WorldWideScience

Sample records for evaluating systematic dependencies

  1. Evaluating Systematic Dependencies of Type Ia Supernovae: The Influence of Progenitor 22Ne Content on Dynamics

    Science.gov (United States)

    Townsley, Dean M.; Jackson, Aaron P.; Calder, Alan C.; Chamulak, David A.; Brown, Edward F.; Timmes, F. X.

    2009-08-01

    We present a theoretical framework for formal study of systematic effects in supernovae Type Ia (SNe Ia) that utilizes two-dimensional simulations to implement a form of the deflagration-detonation transition (DDT) explosion scenario. The framework is developed from a randomized initial condition that leads to a sample of simulated SNe Ia whose 56Ni masses have a similar average and range to those observed, and have many other modestly realistic features such as the velocity extent of intermediate-mass elements. The intended purpose is to enable statistically well defined studies of both physical and theoretical parameters of the SNe Ia explosion simulation. We present here a thorough description of the outcome of the SNe Ia explosions produced by our current simulations. A first application of this framework is utilized to study the dependence of the SNe Ia on the 22Ne content, which is known to be directly influenced by the progenitor stellar population's metallicity. Our study is very specifically tailored to measure how the 22Ne content influences the competition between the rise of plumes of burned material and the expansion of the star before these plumes reach DDT conditions. This influence arises from the dependence of the energy release, progenitor structure, and laminar flame speed on 22Ne content. For this study, we explore these three effects for a fixed carbon content and DDT density. By setting the density at which nucleosynthesis takes place during the detonation phase of the explosion, the competition between plume rise and stellar expansion controls the amount of material in nuclear statistical equilibrium (NSE) and therefore 56Ni produced. Of particular interest is how this influence of 22Ne content compares to the direct modification of the 56Ni mass via the inherent neutron excess as discussed by Timmes et al. Although the outcome following from any particular ignition condition can change dramatically with 22Ne content, with a sample of 20

  2. Integrated Psychosocial and Opioid-Antagonist Treatment for Alcohol Dependence: A Systematic Review of Controlled Evaluations

    Science.gov (United States)

    Vaughn, Michael G.; Howard, Matthew O.

    2004-01-01

    Methodological characteristics and outcomes of 14 controlled clinical investigations of integrated psychosocial and opioid-antagonist alcohol dependence treatment were evaluated. The 14 studies were identified through computerized bibliographic and manual literature searches. Clients receiving integrated psychosocial and opioid-antagonist…

  3. SYSTEMATICALLY MISCLASSIFIED BINARY DEPENDENT VARIABLES.

    Science.gov (United States)

    Tennekoon, Vidhura; Rosenman, Robert

    When a binary dependent variable is misclassified, that is, recorded in the category other than where it really belongs, probit and logit estimates are biased and inconsistent. In some cases the probability of misclassification may vary systematically with covariates, and thus be endogenous. In this paper we develop an estimation approach that corrects for endogenous misclassification, validate our approach using a simulation study, and apply it to the analysis of a treatment program designed to improve family dynamics. Our results show that endogenous misclassification could lead to potentially incorrect conclusions unless corrected using an appropriate technique.

  4. Pain and Opioid Addiction: A Systematic Review and Evaluation of Pain Measurement in Patients with Opioid Dependence on Methadone Maintenance Treatment.

    Science.gov (United States)

    Dennis, B B; Bawor, M; Paul, J; Plater, C; Pare, G; Worster, A; Varenbut, M; Daiter, J; Marsh, D C; Desai, D; Thabane, L; Samaan, Z

    2016-01-01

    While chronic pain has been said to impact patient's response to methadone maintenance treatment for opioid dependence, the reported findings are inconsistent. These discrepancies may be a direct result of variations in the measurement of chronic pain or definitions of response to methadone treatment. The goal of this study is to evaluate the association between pain and substance use behaviour to determine the real impact of comorbid pain in the methadone population. We also aim to examine sources of variation across the literature with a specific focus on the measurement of pain. We performed a systematic review using an electronic search strategy across CINAHL, MEDLINE, Web of Science, PsychINFO, EMBASE, and the Cochrane Library including Cochrane Reviews and the Cochrane Central Register of Controlled Trials databases. Title, abstract, as well as full text screening and extraction were performed in duplicate. Studies evaluating the association between chronic pain and methadone maintenance treatment response were eligible for inclusion in this review. Using a sample of 297 methadone patients from the Genetics of Opioid Addiction (GENOA) research collaborative, we assessed the reliability of patient self-reported pain and the validated Brief Pain Inventory (BPI) assessment tool. After screening 826 articles we identified five studies eligible for full text extraction, of which three showed a significant relationship between the presence of pain and the increase in substance abuse among patients on methadone for the treatment of opioid dependence. Studies varied largely in the definitions and measurement of both pain and response to treatment. Results from our validation of pain measurement in the GENOA sample (n=297) showed the use of a simple self-reported pain question is highly correlated to the use of the BPI. Simply asking patients whether they have pain showed a 44.2% sensitivity, 88.8% specificity, 84.4% PPV and 53.6% NPV to the BPI. The area under the

  5. A practice-driven systematic review of dependency analysis solutions

    NARCIS (Netherlands)

    Callo Arias, Trosky B.; Spek, Pieter van der; Avgeriou, Paris

    2011-01-01

    When following architecture-driven strategies to develop large software-intensive systems, the analysis of the dependencies is not an easy task. In this paper, we report a systematic literature review on dependency analysis solutions. Dependency analysis concerns making dependencies due to

  6. Evaluating Dependence Criteria for Caffeine.

    Science.gov (United States)

    Striley, Catherine L W; Griffiths, Roland R; Cottler, Linda B

    2011-12-01

    Background: Although caffeine is the most widely used mood-altering drug in the world, few studies have operationalized and characterized Diagnostic and Statistical Manual IV (DSM-IV) substance dependence criteria applied to caffeine. Methods: As a part of a nosological study of substance use disorders funded by the National Institute on Drug Abuse, we assessed caffeine use and dependence symptoms among high school and college students, drug treatment patients, and pain clinic patients who reported caffeine use in the last 7 days and also reported use of alcohol, nicotine, or illicit drugs within the past year (n=167). Results: Thirty-five percent met the criteria for dependence when all seven of the adopted DSM dependence criteria were used. Rates of endorsement of several of the most applicable diagnostic criteria were as follows: 26% withdrawal, 23% desire to cut down or control use, and 44% continued use despite harm. In addition, 34% endorsed craving, 26% said they needed caffeine to function, and 10% indicated that they talked to a physician or counselor about problems experienced with caffeine. There was a trend towards increased caffeine dependence among those dependent on nicotine or alcohol. Within a subgroup that had used caffeine, alcohol, and nicotine in the past year, 28% fulfilled criteria for caffeine dependence compared to 50% for alcohol and 80% for nicotine. Conclusion: The present study adds to a growing literature suggesting the reliability, validity, and clinical utility of the caffeine dependence diagnosis. Recognition of caffeine dependence in the DSM-V may be clinically useful.

  7. Evaluating clinical librarian services: a systematic review.

    Science.gov (United States)

    Brettle, Alison; Maden-Jenkins, Michelle; Anderson, Lucy; McNally, Rosalind; Pratchett, Tracey; Tancock, Jenny; Thornton, Debra; Webb, Anne

    2011-03-01

      Previous systematic reviews have indicated limited evidence and poor quality evaluations of clinical librarian (CL) services. Rigorous evaluations should demonstrate the value of CL services, but guidance is needed before this can be achieved.   To undertake a systematic review which examines models of CL services, quality, methods and perspectives of clinical librarian service evaluations.   Systematic review methodology and synthesis of evidence, undertaken collaboratively by a group of 8 librarians to develop research and critical appraisal skills.   There are four clear models of clinical library service provision. Clinical librarians are effective in saving health professionals time, providing relevant, useful information and high quality services. Clinical librarians have a positive effect on clinical decision making by contributing to better informed decisions, diagnosis and choice of drug or therapy. The quality of CL studies is improving, but more work is needed on reducing bias and providing evidence of specific impacts on patient care. The Critical Incident Technique as part of a mixed method approach appears to offer a useful approach to demonstrating impact.   This systematic review provides practical guidance regarding the evaluation of CL services. It also provides updated evidence regarding the effectiveness and impact of CL services. The approach used was successful in developing research and critical appraisal skills in a group of librarians. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

  8. Evaluating Dependence Criteria for Caffeine

    OpenAIRE

    Striley, Catherine L.W.; Griffiths, Roland R.; Cottler, Linda B.

    2011-01-01

    Background: Although caffeine is the most widely used mood-altering drug in the world, few studies have operationalized and characterized Diagnostic and Statistical Manual IV (DSM-IV) substance dependence criteria applied to caffeine. Methods: As a part of a nosological study of substance use disorders funded by the National Institute on Drug Abuse, we assessed caffeine use and dependence symptoms among high school and college students, drug treatment patients, and pain clinic patients who re...

  9. Systematic Features and Progenitor Dependence of Core-Collapse Supernovae

    Science.gov (United States)

    Nakamura, Ko; Takiwaki, Tomoya; Kuroda, Takami; Kotake, Kei

    We present our latest results of two-dimensional core-collapse supernova simulations for about 400 progenitors. Our self-consistent supernova models reveal the systematic features of core-collapse supernova properties such as neutrino luminosity and energy spectrum, explosion energy, remnant mass, and yield of radioactive 56Ni. We find that these explosion characteristics tend to show a monotonic increase as a function of mass accretion rate onto a shock. The accretion rate depends on the structure of the progenitor core and its envelope, which is well described by the compactness parameter.

  10. Systematic evaluation of observational methods assessing biomechanical exposures at work

    National Research Council Canada - National Science Library

    Esa-Pekka Takala; Irmeli Pehkonen; Mikael Forsman; Gert-Åke Hansson; Svend Erik Mathiassen; W Patrick Neumann; Gisela Sjøgaard; Kaj Bo Veiersted; Rolf H Westgaard; Jørgen Winkel

    2010-01-01

    Objectives This systematic review aimed to identify published observational methods assessing biomechanical exposures in occupational settings and evaluate them with reference to the needs of different users...

  11. Psychosocial difficulties in alcohol dependence: a systematic review of activity limitations and participation restrictions.

    Science.gov (United States)

    Levola, Jonna; Kaskela, Teemu; Holopainen, Antti; Sabariego, Carla; Tourunen, Jouni; Cieza, Alarcos; Pitkänen, Tuuli

    2014-01-01

    There has been a lack of comprehensive reviews targeting specific aspects of functioning and the difficulties faced by persons with alcohol dependence. The aim of the present review was to systematically compile the existing literature on activity limitations and participation restrictions as defined in the International Classification of Functioning, Disability and Health (ICF) in the context of alcohol dependence. A database search (MEDLINE and PsychINFO) was performed for studies published in English (2005-2012), examining the activity limitations and participation restrictions in alcohol dependence. Using a standardised protocol, information about the studies' characteristics and data on activity limitations and participation restrictions, their evolution, onset, determinants and associations with other variables were extracted from the studies under review. A total of 211 difficulties in activities and participation in persons with alcohol dependence were extracted from 125 papers. The spectrum of studies was wide, and their overall quality was good. A common reason for the exclusion of studies was an inconclusive definition of alcohol dependence. Issues with interpersonal interactions, economic and professional life, dealing with aggression and legal problems were the most frequently reported difficulties. Problems with high-risk behaviours and in seeking appropriate treatment were also common. The most frequent determinants of the onset and evolution of the identified difficulties were factors pertaining to the course of alcohol dependence. These difficulties were rarely the studies' focus; therefore, the data on their underlying causes and courses were limited. The results confirm that alcohol dependence profoundly affects the family and social network of the afflicted person. The treatment of alcohol dependence can contribute to the alleviation of these associated difficulties. The ICF offers a new perspective on evaluating the wide range of difficulties

  12. Mobile phone messaging for illicit drug and alcohol dependence: A systematic review of the literature.

    Science.gov (United States)

    Tofighi, Babak; Nicholson, Joseph M; McNeely, Jennifer; Muench, Frederick; Lee, Joshua D

    2017-07-01

    Mobile phone use has increased dramatically and concurrent with rapid developments in mobile phone-based health interventions. The integration of text messaging interventions promises to optimise the delivery of care for persons with substance dependence with minimal disruption to clinical workflows. We conducted a systematic review to assess the acceptability, feasibility and clinical impact of text messaging interventions for persons with illicit drug and alcohol dependence. Studies were required to evaluate the use of text messaging as an intervention for persons who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition criterion for a diagnosis of illicit drug and/or alcohol dependence. Authors searched for articles published to date in MEDLINE (pubmed.gov), the Cochrane Library, EMBASE, CINAHL, Google Scholar and PsychINFO. Eleven articles met the search criteria for this review and support the acceptability and feasibility of text messaging interventions for addressing illicit drug and alcohol dependence. Most studies demonstrated improved clinical outcomes, medication adherence and engagement with peer support groups. Text messaging interventions also intervened on multiple therapeutic targets such as appointment attendance, motivation, self-efficacy, relapse prevention and social support. Suggestions for future research are described, including intervention design features, clinician contact, privacy measures and integration of behaviour change theories. Text messaging interventions offer a feasible platform to address a range of substances (i.e. alcohol, methamphetamine, heroin and alcohol), and there is increasing evidence supporting further larger-scale studies. [Tofighi B, Nicholson JM, McNeely J, Muench F, Lee JD. Mobile phone messaging for illicit drug and alcohol dependence: A systematic review of the literature. Drug Alcohol Rev 2017;36:477-491]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

  13. A systematic comparative evaluation of biclustering techniques.

    Science.gov (United States)

    Padilha, Victor A; Campello, Ricardo J G B

    2017-01-23

    Biclustering techniques are capable of simultaneously clustering rows and columns of a data matrix. These techniques became very popular for the analysis of gene expression data, since a gene can take part of multiple biological pathways which in turn can be active only under specific experimental conditions. Several biclustering algorithms have been developed in the past recent years. In order to provide guidance regarding their choice, a few comparative studies were conducted and reported in the literature. In these studies, however, the performances of the methods were evaluated through external measures that have more recently been shown to have undesirable properties. Furthermore, they considered a limited number of algorithms and datasets. We conducted a broader comparative study involving seventeen algorithms, which were run on three synthetic data collections and two real data collections with a more representative number of datasets. For the experiments with synthetic data, five different experimental scenarios were studied: different levels of noise, different numbers of implanted biclusters, different levels of symmetric bicluster overlap, different levels of asymmetric bicluster overlap and different bicluster sizes, for which the results were assessed with more suitable external measures. For the experiments with real datasets, the results were assessed by gene set enrichment and clustering accuracy. We observed that each algorithm achieved satisfactory results in part of the biclustering tasks in which they were investigated. The choice of the best algorithm for some application thus depends on the task at hand and the types of patterns that one wants to detect.

  14. Guidelines for planning, conducting, reporting and evaluating Systematic Reviews in Sport and Health

    Directory of Open Access Journals (Sweden)

    Teresa Bento

    2014-06-01

    Full Text Available Reliable summaries of the available evidence are essential to help researchers and practitioners make well-informed decisions. For this reason, the quality of the final result depends on the accuracy in each stage of the development of a systematic review. The aim of the present study is to draw guidelines and recommendations for planning, conducting, reporting and evaluating systematic reviews that support the work of researchers and reviewers. Initially, we address the main characteristics and differences of a systematic review compared to other literature reviews. Then, we describe the main procedures and concerns to be considered in each phase of developing a systematic review. Finally, we present a commented version of a checklist for reporting systematic reviews and guide the reader. We intend to contribute to the set of standards for the structure and quality of knowledge published in review papers, in the fields of Sport and Health, which support more informed decisions.

  15. Digital pathology: A systematic evaluation of the patent landscape

    OpenAIRE

    Cucoranu, Ioan C.; Parwani, Anil V.; Vepa, Suryanarayana; Weinstein, Ronald S.; Pantanowitz, Liron

    2014-01-01

    Introduction: Digital pathology is a relatively new field. Inventors of technology in this field typically file for patents to protect their intellectual property. An understanding of the patent landscape is crucial for companies wishing to secure patent protection and market dominance for their products. To our knowledge, there has been no prior systematic review of patents related to digital pathology. Therefore, the aim of this study was to systematically identify and evaluate United State...

  16. Systematic evaluation of reference protein normalization (RPN in proteomic experiments.

    Directory of Open Access Journals (Sweden)

    Henrik eZauber

    2013-02-01

    Full Text Available Quantitative comparative analyses of protein abundances and their modifications have become a widely used technique in studying various biological questions. In the past years, several methods for quantitative proteomics were established using stable-isotope labeling and label-free approaches. We systematically evaluated the application of reference protein normalization (RPN for proteomic experiments using a high mass accuracy LC-MS/MS platform. In RPN each peptide intensity is normalized to an average protein intensity of a spiked-in reference protein per sample. The main advantage of this method, compared to other label-free normalization strategies, is to avoid fraction of total based relative analysis of proteomic data, which is often very much dependent on sample complexity. We could show that reference protein ion intensity sums are reproducible enough to ensure reliable normalization. We validated the RPN strategy by analyzing changes in protein abundances induced by nutrient starvation in Arabidopsis. Beyond that, we provide a principle guideline for determining optimal combination of sample protein and reference protein load on individual LC-MS/MS systems.

  17. Systematic evaluation of observational methods assessing biomechanical exposures at work

    DEFF Research Database (Denmark)

    Takala, Esa-Pekka; Pehkonen, Irmeli; Forsman, Mikael

    2010-01-01

    to September 2008. Methods were included if they were primarily based on the systematic observation of work, the observation target was the human body, and the method was clearly described in the literature. A systematic evaluation procedure was developed to assess concurrent and predictive validity...... difficult to observe correctly. Intra- and inter-observer repeatability were reported for 7 and 17 methods, respectively, and were judged mostly to be good or moderate. CONCLUSIONS: With training, observers can reach consistent results on clearly visible body postures and work activities. Many observational...

  18. Arcade - A Formal, Extensible, Model-based Dependability Evaluation Framework

    NARCIS (Netherlands)

    Boudali, H.; Crouzen, Pepijn; Haverkort, Boudewijn R.H.M.; Kuntz, G.W.M.; Stoelinga, Mariëlle Ida Antoinette

    This paper discusses the requirements that a suitable formalism for dependability modeling/evaluation should possess. We also discuss the outline of Arcade, an architectural dependability formalism that we are developing.

  19. Maritime clusters productivity and competitiveness evaluation methods: Systematic approach

    Directory of Open Access Journals (Sweden)

    Viederytė Rasa

    2014-01-01

    Full Text Available Many scientists underline the importance of the clusters as agglomerated industries, working for the same purpose with joined resources and potential. This article analyses the basic assumptions which turn organizations to be clustered: the Productivity and the Competitiveness. For the evaluation of those assumptions in Maritime Clusters, many of the methods practically are applied without systematic approach - some are focused to the port efficiency, others provide quantity of resources growth dynamics, infrastructure parameters or even explain productivity and competitiveness as the same assumption. This article presents the analysis of Maritime Clusters' Productivity and Competitiveness evaluation methods in systematic approach, providing the analysis on the mostly-used variables and parameters of the evaluation the assumptions to be examined.

  20. [Systematic economic assessment and quality evaluation for traditional Chinese medicines].

    Science.gov (United States)

    Sun, Xiao; Guo, Li-ping; Shang, Hong-cai; Ren, Ming; Lei, Xiang

    2015-05-01

    To learn about the economic studies on traditional Chinese medicines in domestic literatures, in order to analyze the current economic assessment of traditional Chinese medicines and explore the existing problems. Efforts were made to search CNKI, VIP, Wanfang database and CBM by computer and include all literatures about economic assessment of traditional Chinese medicines published on professional domestic journals in the systematic assessment and quality evaluation. Finally, 50 articles were included in the study, and the systematic assessment and quality evaluation were made for them in terms of titles, year, authors' identity, expense source, disease type, study perspective, study design type, study target, study target source, time limit, cost calculation, effect indicator, analytical technique and sensitivity analysis. The finally quality score was 0.74, which is very low. The results of the study showed insufficient studies on economics of traditional Chinese medicines, short study duration and simple evaluation methods, which will be solved through unremitting efforts in the future.

  1. Economic evaluation of dental sealants: A systematic literature review.

    Science.gov (United States)

    Akinlotan, Marvellous; Chen, Bradley; Fontanilla, Tiana M; Chen, Annie; Fan, Victoria Y

    2017-09-06

    To systematically review the literature on economic evaluations of dental sealants and examine the costs and effectiveness of caries prevention using sealants. Of 21 full-text articles examined, a total of 13 were included in this study. These studies are grouped by the type of intervention as follows: (i) sealants compared with no sealants; (ii) sealants compared with other forms of caries prevention; (iii) resin-based sealants compared with glass-ionomer sealants; (iv) different sealing strategies in primary teeth; (v) different sealing strategies in permanent teeth; and (vi) sealants based on school- or clinic-based setting of delivery. All currency is reported in constant 2010 US$. Cost-effectiveness analyses differed due to varying study designs, assumptions, sealant delivery settings, outcomes, caries risk assessment and study durations. Findings varied on the cost-effectiveness of sealants compared with other caries-preventive strategies. Under the assumption of equal caries risk, always sealing primary molars appeared to be the most effective strategy, whereas risk-based sealing was the optimal strategy with differing caries risk. Studies that assessed sealing strategies in permanent teeth reported that risk-based sealing was more cost-effective than not sealing, but they differed on the cost-effectiveness of risk-based seal compared with non-risk-based seal. Sealants delivered in school settings had mixed results on costs but were as equally effective as sealants delivered in private practices. The cost-effectiveness of sealants is dependent on the conditions of delivery. The list of cost-effectiveness ratios for each intervention can support policy makers to estimate expected returns on their investments in dental sealants. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Evaluating information skills training in health libraries: a systematic review.

    Science.gov (United States)

    Brettle, Alison

    2007-12-01

    Systematic reviews have shown that there is limited evidence to demonstrate that the information literacy training health librarians provide is effective in improving clinicians' information skills or has an impact on patient care. Studies lack measures which demonstrate validity and reliability in evaluating the impact of training. To determine what measures have been used; the extent to which they are valid and reliable; to provide guidance for health librarians who wish to evaluate the impact of their information skills training. Systematic review methodology involved searching seven databases, and personal files. Studies were included if they were about information skills training, used an objective measure to assess outcomes, and occurred in a health setting. Fifty-four studies were included in the review. Most outcome measures used in the studies were not tested for the key criteria of validity and reliability. Three tested for validity and reliability are described in more detail. Selecting an appropriate measure to evaluate the impact of training is a key factor in carrying out any evaluation. This systematic review provides guidance to health librarians by highlighting measures used in various circumstances, and those that demonstrate validity and reliability.

  3. Modafinil Treatment of Cocaine Dependence: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Sangroula, Dinesh; Motiwala, Fatima; Wagle, Bivek; Shah, Vivek C; Hagi, Katsuhiko; Lippmann, Steven

    2017-08-24

    Currently, there is none FDA-approved medication to treat cocaine dependency. Studies conducted with various medications, including antipsychotics, antidepressants, anticonvulsants, and others, revealed inconsistent results. To meta-analytically investigate the efficacy and safety of modafinil in the treatment of cocaine-dependent patients. Randomized controlled trials with ≥20 subjects comparing the numerical therapeutic outcomes of modafinil with placebo were identified in databases, such as PUBMED, psycINFO, EMBASE, and Clinicaltrials.gov. Relevant data on efficacy and safety were extracted. Relative risk (RR) and standardized mean difference were applied for reporting dichotomous and continuous outcomes respectively. Random effects, subgroup, and meta-regression analyses were conducted to further explore the results and evaluate for any moderators. In total, 11 studies (participants = 896, duration = 6.7 ± 1.9 weeks) comparing modafinil with placebo were systematically analyzed, which indicated that modafinil was not superior to placebo in improving the treatment retention rate (studies = 11, participants = 891, RR = 1.030, 95% CI = 0.918-1.156, p = .613). Similarly, data from 7/11 studies did not evidence superiority of modafinil in achieving cocaine abstinence (participants = 696, RR = 1.259, 95% CI = 0.813-1.949, p = .302). However, subgroup analysis of six studies conducted in the United States demonstrated superiority of modafinil in cocaine abstinence rate (studies = 6, participants = 669, 95% CI = 1.027-2.020, p = 0.035). In addition, no evidence suggested modafinil-related discontinuation or specific adverse events than placebo. Overall, there is no evidence to conclude superiority of modafinil in increasing cocaine abstinence and treatment retention rate. However, promising result in subgroup analysis of cocaine abstinence, secondary outcomes, and good safety profile urged the need of larger studies to derive more conclusive results.

  4. Systematic comparative evaluation of methods for investigating the TCRβ repertoire

    DEFF Research Database (Denmark)

    Liu, Xiao; Zhang, Wei; Zeng, Xiaojing

    2016-01-01

    advantages and disadvantages; however, a systematic evaluation and direct comparison of them would benefit researchers in the selection of the most suitable method. In this study, we used both pooled control plasmids and spiked-in cells to benchmark the MPCR bias. RNA from three healthy donors...... variability was smaller compared with the biological variability. Through direct comparison, these findings provide novel insights into the two experimental methods, which will prove to be valuable in immune repertoire research and its interpretation....

  5. A systematic review on the practice of evaluating visualization.

    Science.gov (United States)

    Isenberg, Tobias; Isenberg, Petra; Chen, Jian; Sedlmair, Michael; Möller, Torsten

    2013-12-01

    We present an assessment of the state and historic development of evaluation practices as reported in papers published at the IEEE Visualization conference. Our goal is to reflect on a meta-level about evaluation in our community through a systematic understanding of the characteristics and goals of presented evaluations. For this purpose we conducted a systematic review of ten years of evaluations in the published papers using and extending a coding scheme previously established by Lam et al. [2012]. The results of our review include an overview of the most common evaluation goals in the community, how they evolved over time, and how they contrast or align to those of the IEEE Information Visualization conference. In particular, we found that evaluations specific to assessing resulting images and algorithm performance are the most prevalent (with consistently 80-90% of all papers since 1997). However, especially over the last six years there is a steady increase in evaluation methods that include participants, either by evaluating their performances and subjective feedback or by evaluating their work practices and their improved analysis and reasoning capabilities using visual tools. Up to 2010, this trend in the IEEE Visualization conference was much more pronounced than in the IEEE Information Visualization conference which only showed an increasing percentage of evaluation through user performance and experience testing. Since 2011, however, also papers in IEEE Information Visualization show such an increase of evaluations of work practices and analysis as well as reasoning using visual tools. Further, we found that generally the studies reporting requirements analyses and domain-specific work practices are too informally reported which hinders cross-comparison and lowers external validity.

  6. Systematic evaluation of observational methods assessing biomechanical exposures at work

    DEFF Research Database (Denmark)

    Takala, Esa-Pekka; Irmeli, Pehkonen; Forsman, Mikael

    2009-01-01

    is suitable for all purposes. The selection and use of methods has often been based on tradition rather than on a critical evaluation, because actors are generally not aware of methods outside of their own realm of experience.   Aims   The aim of this project was to systematically and critically evaluate.......ttl.fi/workloadexposuremethods The site also includes a tool to sort the methods according to the items used in the evaluation so that the user can select and compare methods for his/her purposes.   Acknowledgments. This study was financially supported by the Nordic Council of Ministers (Project 411040 - 70107)        ...... in the electronic databases and other sources identified 29 observational methods. The methods were evaluated for the aspects related to their reliability and usability for different purposes. The results of evaluation will be found in internet with a tool that helps the user to search for most suitable method...

  7. A systematic review of economic evaluations of therapy in asthma

    Directory of Open Access Journals (Sweden)

    Katayoun Bahadori

    2010-08-01

    Full Text Available Katayoun Bahadori1, Bradley S Quon2, Mary M Doyle-Waters1, Carlo Marra3, J Mark FitzGerald21Centre for Clinical Epidemiology and Evaluation (C2E2, 2Department of Medicine, Respiratory Division, 3Faculty of Pharmaceutical Sciences, UBC, Vancouver, BC, CanadaBackground: Asthma’s cost-effectiveness is a major consideration in the evaluation of its treatment options. Our objective was to perform a systematic review of the cost-effectiveness of asthma medications.Methods: We performed a systematic search of MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, OHE-HEED, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Health Technology Assessments Database, NHS Economic Evaluation Database, and Web of Science and reviewed references from key articles between 1990 and Jan 2008.Results: A total of 49 RCTs met the inclusion criteria. Maintenance therapy with inhaled corticosteroids was found to be very cost-effective and in uncontrolled asthmatics patients currently being treated with ICS, the combination of an ICS/LABA represents a safe, cost-effective treatment. The simplified strategy using budesonide and formoterol for maintenance and reliever therapy was also found to be as cost-effective as salmeterol/fluticasone plus salbutamol. Omalizumab was found to be cost-effective. An important caveat with regard to the published literature is the relatively high proportion of economic evaluations which are funded by the manufacturers of specific drug treatments.Conclusion: Future studies should be completed independent of industry support and ensure that the comparator arms within studies should include dosages of drugs that are equivalent.Keywords: asthma, medication, cost-effectiveness, cost of illness, economic costs

  8. Systematic evaluation of personal genome services for Japanese individuals.

    Science.gov (United States)

    Kido, Takashi; Kawashima, Minae; Nishino, Seiji; Swan, Melanie; Kamatani, Naoyuki; Butte, Atul J

    2013-11-01

    Disease risk prediction (DRP) is one of the most important challenges in personal genome research. Although many direct-to-consumer genetic test (DTC) companies have begun to offer personal genome services for DRP, there is still no consensus on what constitutes a gold-standard service. Here, we systematically evaluated the distributions of DRPs from three DTC companies, that is, 23andMe, Navigenics and deCODEme, for 22 diseases using three Japanese samples. We systematically quantified and analyzed the differences between each DTC company's DRPs. Our independency test showed that the overall prediction results were correlated with each other, but not perfectly matched; less than onethird mismatching of the opposite direction occurred in eight diseases. Moreover, we found that the differences could mainly be attributed to four factors: (1) single nucleotide polymorphism (SNP) selection, (2) average risk estimation, (3) the disease risk calculation algorithm and (4) ethnicity adjustment. In particular, only 7.1% of SNPs over 22 diseases were reviewed by all three companies. Therefore, development of a universal core SNPs list for non-Caucasian samples will be important for achieving better prediction capacity for Japanese samples. This systematic methodology provides useful insights for improving the capacity of DRPs in future personal genome services.

  9. Development of dependence following treatment with opioid analgesics for pain relief: a systematic review.

    Science.gov (United States)

    Minozzi, Silvia; Amato, Laura; Davoli, Marina

    2013-04-01

    To assess the incidence or prevalence of opioid dependence syndrome in adults (with and without previous history of substance abuse) following treatment with opioid analgesics for pain relief. Medline, Embase, CINHAL and the Cochrane Library were searched up to January 2011. Systematic reviews and primary studies were included if they reported data about incidence or prevalence of opioid dependence syndrome (as defined by DSM-IV or ICD-10) in patients receiving strong opioids (or opioid-type analgesics) for treatment of acute or chronic pain due to any physical condition. The data were abstracted, and the methodological quality was assessed using validated checklists. Data were extracted from 17 studies involving a total of 88 235 participants. The studies included three systematic reviews, one randomized controlled trial, eight cross-sectional studies and four uncontrolled case series. Most studies included adult patients with chronic non-malignant pain; two also included patients with cancer pain; only one included patients with a previous history of dependence. Incidence ranged from 0 to 24% (median 0.5%); prevalence ranged from 0 to 31% (median 4.5%). The available evidence suggests that opioid analgesics for chronic pain conditions are not associated with a major risk for developing dependence. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

  10. Spatial dependent systematic error correction and colour coefficients for the 2-m telescope of theRozhen National Astronomical Observatory

    Science.gov (United States)

    Mihov, Boyko M.; Slavcheva-Mihova, Lyuba S.

    2017-07-01

    Spatial dependent systematic error of the instrumental magnitudes on the CCD frames taken at the 2-m telescope of the Rozhen National Astronomical Observatory due to scattered light was present till mid-June 2009. We derive and discuss (U)BVRI spatial dependent systematic error correction, together with colour coefficients, on the basis of archival data. The simultaneous estimation of the two types of coefficients - spatial and colour, ensures the detachment of the two effects, and, accordingly, the higher accuracy in the coefficient estimates. The application of the spatial dependent systematic error correction to the data in the period discussed would increase photometry accuracy.

  11. Systematic evaluation of atmospheric chemistry-transport model CHIMERE

    Science.gov (United States)

    Khvorostyanov, Dmitry; Menut, Laurent; Mailler, Sylvain; Siour, Guillaume; Couvidat, Florian; Bessagnet, Bertrand; Turquety, Solene

    2017-04-01

    Regional-scale atmospheric chemistry-transport models (CTM) are used to develop air quality regulatory measures, to support environmentally sensitive decisions in the industry, and to address variety of scientific questions involving the atmospheric composition. Model performance evaluation with measurement data is critical to understand their limits and the degree of confidence in model results. CHIMERE CTM (http://www.lmd.polytechnique.fr/chimere/) is a French national tool for operational forecast and decision support and is widely used in the international research community in various areas of atmospheric chemistry and physics, climate, and environment (http://www.lmd.polytechnique.fr/chimere/CW-articles.php). This work presents the model evaluation framework applied systematically to the new CHIMERE CTM versions in the course of the continuous model development. The framework uses three of the four CTM evaluation types identified by the Environmental Protection Agency (EPA) and the American Meteorological Society (AMS): operational, diagnostic, and dynamic. It allows to compare the overall model performance in subsequent model versions (operational evaluation), identify specific processes and/or model inputs that could be improved (diagnostic evaluation), and test the model sensitivity to the changes in air quality, such as emission reductions and meteorological events (dynamic evaluation). The observation datasets currently used for the evaluation are: EMEP (surface concentrations), AERONET (optical depths), and WOUDC (ozone sounding profiles). The framework is implemented as an automated processing chain and allows interactive exploration of the results via a web interface.

  12. Evaluating investment in quality improvement capacity building: a systematic review.

    Science.gov (United States)

    Mery, Gustavo; Dobrow, Mark J; Baker, G Ross; Im, Jennifer; Brown, Adalsteinn

    2017-02-20

    Leading health systems have invested in substantial quality improvement (QI) capacity building, but little is known about the aggregate effect of these investments at the health system level. We conducted a systematic review to identify key steps and elements that should be considered for system-level evaluations of investment in QI capacity building. We searched for evaluations of QI capacity building and evaluations of QI training programmes. We included the most relevant indexed databases in the field and a strategic search of the grey literature. The latter included direct electronic scanning of 85 relevant government and institutional websites internationally. Data were extracted regarding evaluation design and common assessment themes and components. 48 articles met the inclusion criteria. 46 articles described initiative-level non-economic evaluations of QI capacity building/training, while 2 studies included economic evaluations of QI capacity building/training, also at the initiative level. No system-level QI capacity building/training evaluations were found. We identified 17 evaluation components that fit within 5 overarching dimensions (characteristics of QI training; characteristics of QI activity; individual capacity; organisational capacity and impact) that should be considered in evaluations of QI capacity building. 8 key steps in return-on-investment (ROI) assessments in QI capacity building were identified: (1) planning-stakeholder perspective; (2) planning-temporal perspective; (3) identifying costs; (4) identifying benefits; (5) identifying intangible benefits that will not be included in the ROI estimation; (6) discerning attribution; (7) ROI calculations; (8) sensitivity analysis. The literature on QI capacity building evaluation is limited in the number and scope of studies. Our findings, summarised in a Framework to Guide Evaluations of QI Capacity Building, can be used to start closing this knowledge gap. Published by the BMJ Publishing

  13. Assisting allied health in performance evaluation: a systematic review.

    Science.gov (United States)

    Lizarondo, Lucylynn; Grimmer, Karen; Kumar, Saravana

    2014-11-14

    Performance evaluation raises several challenges to allied health practitioners and there is no agreed approach to measuring or monitoring allied health service performance. The aim of this review was to examine the literature on performance evaluation in healthcare to assist in the establishment of a framework that can guide the measurement and evaluation of allied health clinical service performance. This review determined the core elements of a performance evaluation system, tools for evaluating performance, and barriers to the implementation of performance evaluation. A systematic review of the literature was undertaken. Five electronic databases were used to search for relevant articles: MEDLINE, Embase, CINAHL, PsychInfo, and Academic Search Premier. Articles which focussed on any allied health performance evaluation or those which examined performance in health care in general were considered in the review. Content analysis was used to synthesise the findings from individual articles. A total of 37 articles were included in the review. The literature suggests there are core elements involved in performance evaluation which include prioritising clinical areas for measurement, setting goals, selecting performance measures, identifying sources of feedback, undertaking performance measurement, and reporting the results to relevant stakeholders. The literature describes performance evaluation as multi-dimensional, requiring information or data from more than one perspective to provide a rich assessment of performance. A range of tools or instruments are available to capture various perspectives and gather a comprehensive picture of health care quality. Every allied health care delivery system has different performance needs and will therefore require different approaches. However, there are core processes that can be used as a framework to evaluate allied health performance. A careful examination of barriers to performance evaluation and subsequent tailoring of

  14. Evaluation of Health Economics in Radiation Oncology: A Systematic Review

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Timothy K.; Goodman, Chris D. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Boldt, R. Gabriel [London Health Sciences Centre, London, Ontario (Canada); Warner, Andrew; Palma, David A. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Rodrigues, George B. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada); Lock, Michael I. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Mishra, Mark V. [Department of Radiation Oncology, University of Maryland, Baltimore, Maryland (United States); Zaric, Gregory S. [Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada); Ivey Business School, Western University, London, Ontario (Canada); Louie, Alexander V., E-mail: Dr.alexlouie@gmail.com [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada)

    2016-04-01

    Purpose: Despite the rising costs in radiation oncology, the impact of health economics research on radiation therapy practice analysis patterns is unclear. We performed a systematic review of cost-effectiveness analyses (CEAs) and cost-utility analyses (CUAs) to identify trends in reporting quality in the radiation oncology literature over time. Methods and Materials: A systematic review of radiation oncology economic evaluations up to 2014 was performed, using MEDLINE and EMBASE databases. The Consolidated Health Economic Evaluation Reporting Standards guideline informed data abstraction variables including study demographics, economic parameters, and methodological details. Tufts Medical Center CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified by 3 time periods (1995-2004, 2005-2009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time. Results: In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement (67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (P<.001), health care payer perspective (P=.019), sensitivity analyses using multivariate (P=.043) or probabilistic methods (P=.011), incremental cost-effectiveness threshold (P<.001), secondary source utility weights (P=.010), and cost effectiveness acceptability curves (P=.049). There was a trend toward improvement in Tuft scores over time (P=.065). Conclusions: Recent reports demonstrate improved reporting rates in economic evaluations; however, there remains significant room for improvement as reporting rates are still suboptimal. As fiscal pressures rise, we will rely on economic assessments to guide our practice decisions

  15. Systematic review of methods for evaluating healthcare research economic impact

    Directory of Open Access Journals (Sweden)

    Majdzadeh Reza

    2010-03-01

    Full Text Available Abstract Background The economic benefits of healthcare research require study so that appropriate resources can be allocated to this research, particularly in developing countries. As a first step, we performed a systematic review to identify the methods used to assess the economic impact of healthcare research, and the outcomes. Method An electronic search was conducted in relevant databases using a combination of specific keywords. In addition, 21 relevant Web sites were identified. Results The initial search yielded 8,416 articles. After studying titles, abstracts, and full texts, 18 articles were included in the analysis. Eleven other reports were found on Web sites. We found that the outcomes assessed as healthcare research payback included direct cost-savings, cost reductions in healthcare delivery systems, benefits from commercial advancement, and outcomes associated with improved health status. Two methods were used to study healthcare research payback: macro-economic studies, which examine the relationship between research studies and economic outcome at the aggregated level, and case studies, which examine specific research projects to assess economic impact. Conclusions Our study shows that different methods and outcomes can be used to assess the economic impacts of healthcare research. There is no unique methodological approach for the economic evaluation of such research. In our systematic search we found no research that had evaluated the economic return of research in low and middle income countries. We therefore recommend a consensus on practical guidelines at international level on the basis of more comprehensive methodologies (such as Canadian Academic of Health Science and payback frameworks in order to build capacity, arrange for necessary informative infrastructures and promote necessary skills for economic evaluation studies.

  16. Sleep disturbance in family caregivers of children who depend on medical technology: A systematic review.

    Science.gov (United States)

    Keilty, Krista; Cohen, Eyal; Ho, Michelle; Spalding, Karen; Stremler, Robyn

    2015-01-01

    Society relies on family caregivers of children who depend on medical technology (e.g. mechanical ventilation), to provide highly skilled and vigilant care in their homes 24 hours per day. Sleep disturbance is among the most common complaints of these caregivers. The purpose of this review is to systematically examine studies reporting on sleep outcomes in family caregivers of technology dependent children. All relevant databases were systematically searched: MEDLINE, EMBASE, PsycINFO and CINAHL. Given the heterogeneity of the studies, a qualitative analysis was completed and thus results of this review are presented as a narrative. Thirteen studies were retrieved that met eligibility criteria for inclusion. All of the studies reported on family caregivers of children with medical complexity living at home. Moreover, all of the studies relied entirely on self-report, not objective sleep measures. No intervention studies were found. Sleep disturbance was found to be common (51-100%) along with caregiver reports of poor sleep quality. Sleep quantity was seldom measured, but was found in the few studies that did, to be approximately 6 hours, or less than recommendations for optimal health and daytime function. Multiple caregiver, child and environmental factors were also identified that may negatively influence caregiver sleep, health and daytime function. Findings of this review suggest that family caregivers of children with medical complexity who depend on medical technology achieve poor sleep quality and quantity that may place them at risk of the negative consequences of sleep deprivation. Recommendations for practice include that health care providers routinely assess for sleep disturbance in this vulnerable population. The review also suggests that studies using objective sleep measurement are needed to more fully characterize sleep and inform the development of targeted interventions to promote sleep in family caregivers of technology dependent children.

  17. Cigarette smoking, nicotine dependence and anxiety disorders: a systematic review of population-based, epidemiological studies

    Directory of Open Access Journals (Sweden)

    Moylan Steven

    2012-10-01

    Full Text Available Abstract Background Multiple studies have demonstrated that rates of smoking and nicotine dependence are increased in individuals with anxiety disorders. However, significant variability exists in the epidemiological literature exploring this relationship, including study design (cross-sectional versus prospective, the population assessed (random sample versus clinical population and diagnostic instrument utilized. Methods We undertook a systematic review of population-based observational studies that utilized recognized structured clinical diagnostic criteria (Diagnostic and Statistical Manual of Mental Disorders (DSM or International Classification of Diseases (ICD for anxiety disorder diagnosis to investigate the relationship between cigarette smoking, nicotine dependence and anxiety disorders. Results In total, 47 studies met the predefined inclusion criteria, with 12 studies providing prospective information and 5 studies providing quasiprospective information. The available evidence suggests that some baseline anxiety disorders are a risk factor for initiation of smoking and nicotine dependence, although the evidence is heterogeneous and many studies did not control for the effect of comorbid substance use disorders. The identified evidence however appeared to more consistently support cigarette smoking and nicotine dependence as being a risk factor for development of some anxiety disorders (for example, panic disorder, generalized anxiety disorder, although these findings were not replicated in all studies. A number of inconsistencies in the literature were identified. Conclusions Although many studies have demonstrated increased rates of smoking and nicotine dependence in individuals with anxiety disorders, there is a limited and heterogeneous literature that has prospectively examined this relationship in population studies using validated diagnostic criteria. The most consistent evidence supports smoking and nicotine dependence as

  18. Cigarette smoking, nicotine dependence and anxiety disorders: a systematic review of population-based, epidemiological studies

    Science.gov (United States)

    2012-01-01

    Background Multiple studies have demonstrated that rates of smoking and nicotine dependence are increased in individuals with anxiety disorders. However, significant variability exists in the epidemiological literature exploring this relationship, including study design (cross-sectional versus prospective), the population assessed (random sample versus clinical population) and diagnostic instrument utilized. Methods We undertook a systematic review of population-based observational studies that utilized recognized structured clinical diagnostic criteria (Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD)) for anxiety disorder diagnosis to investigate the relationship between cigarette smoking, nicotine dependence and anxiety disorders. Results In total, 47 studies met the predefined inclusion criteria, with 12 studies providing prospective information and 5 studies providing quasiprospective information. The available evidence suggests that some baseline anxiety disorders are a risk factor for initiation of smoking and nicotine dependence, although the evidence is heterogeneous and many studies did not control for the effect of comorbid substance use disorders. The identified evidence however appeared to more consistently support cigarette smoking and nicotine dependence as being a risk factor for development of some anxiety disorders (for example, panic disorder, generalized anxiety disorder), although these findings were not replicated in all studies. A number of inconsistencies in the literature were identified. Conclusions Although many studies have demonstrated increased rates of smoking and nicotine dependence in individuals with anxiety disorders, there is a limited and heterogeneous literature that has prospectively examined this relationship in population studies using validated diagnostic criteria. The most consistent evidence supports smoking and nicotine dependence as increasing the risk of

  19. Meta-evaluation of published studies on evaluation of health disaster preparedness exercises through a systematic review.

    Science.gov (United States)

    Sheikhbardsiri, Hojjat; Yarmohammadian, Mohammad H; Khankeh, Hamid Reza; Nekoei-Moghadam, Mahmoud; Raeisi, Ahmad Reza

    2018-01-01

    Exercise evaluation is one of the most important steps and sometimes neglected in designing and taking exercises, in this stage of exercise, it systematically identifying, gathering, and interpreting related information to indicate how an exercise has fulfilled its objectives. The present study aimed to assess the most important evaluation techniques applied in evaluating health exercises for emergencies and disasters. This was meta-evaluation study through a systematic review. In this research, we searched papers based on specific and relevant keywords in research databases including ISI web of science, PubMed, Scopus, Science Direct, Ovid, ProQuest, Wiley, Google Scholar, and Persian database such as ISC and SID. The search keywords and strategies are followed; "simulation," "practice," "drill," "exercise," "instrument," "tool," "questionnaire," " measurement," "checklist," "scale," "test," "inventory," "battery," "evaluation," "assessment," "appraisal," "emergency," "disaster," "cricise," "hazard," "catastrophe,: "hospital", "prehospital," "health centers," "treatment centers," were used in combination with Boolean operators OR and AND. The research findings indicate that there are different techniques and methods for data collection to evaluate performance exercises of health centers and affiliated organizations in disasters and emergencies including debriefing inventories, self-report, questionnaire, interview, observation, shooting video, and photographing, electronic equipment which can be individually or collectively used depending on exercise objectives or purposes. Taking exercise in the health sector is one of the important steps in preparation and implementation of disaster risk management programs. This study can be thus utilized to improve preparedness of different sectors of health system according to the latest available evaluation techniques and methods for better implementation of disaster exercise evaluation stages.

  20. Global economic evaluations of rotavirus vaccines: A systematic review.

    Science.gov (United States)

    Kotirum, Surachai; Vutipongsatorn, Naaon; Kongpakwattana, Khachen; Hutubessy, Raymond; Chaiyakunapruk, Nathorn

    2017-06-08

    World Health Organization (WHO) recommends Rotavirus vaccines to prevent and control rotavirus infections. Economic evaluations (EE) have been considered to support decision making of national policy. Summarizing global experience of the economic value of rotavirus vaccines is crucial in order to encourage global WHO recommendations for vaccine uptake. Therefore, a systematic review of economic evaluations of rotavirus vaccine was conducted. We searched Medline, Embase, NHS EED, EconLit, CEA Registry, SciELO, LILACS, CABI-Global Health Database, Popline, World Bank - e-Library, and WHOLIS. Full economic evaluations studies, published from inception to November 2015, evaluating Rotavirus vaccines preventing Rotavirus infections were included. The methods, assumptions, results and conclusions of the included studies were extracted and appraised using WHO guide for standardization of EE of immunization programs. 104 relevant studies were included. The majority of studies were conducted in high-income countries. Cost-utility analysis was mostly reported in many studies using incremental cost-effectiveness ratio per DALY averted or QALY gained. Incremental cost per QALY gained was used in many studies from high-income countries. Mass routine vaccination against rotavirus provided the ICERs ranging from cost-saving to highly cost-effective in comparison to no vaccination among low-income countries. Among middle-income countries, vaccination offered the ICERs ranging from cost-saving to cost-effective. Due to low- or no subsidized price of rotavirus vaccines from external funders, being not cost-effective was reported in some high-income settings. Mass vaccination against rotavirus was generally found to be cost-effective, particularly in low- and middle-income settings according to the external subsidization of vaccine price. On the other hand, it may not be a cost-effective intervention at market price in some high-income settings. This systematic review provides

  1. Better duplicate detection for systematic reviewers: evaluation of Systematic Review Assistant-Deduplication Module.

    Science.gov (United States)

    Rathbone, John; Carter, Matt; Hoffmann, Tammy; Glasziou, Paul

    2015-01-14

    A major problem arising from searching across bibliographic databases is the retrieval of duplicate citations. Removing such duplicates is an essential task to ensure systematic reviewers do not waste time screening the same citation multiple times. Although reference management software use algorithms to remove duplicate records, this is only partially successful and necessitates removing the remaining duplicates manually. This time-consuming task leads to wasted resources. We sought to evaluate the effectiveness of a newly developed deduplication program against EndNote. A literature search of 1,988 citations was manually inspected and duplicate citations identified and coded to create a benchmark dataset. The Systematic Review Assistant-Deduplication Module (SRA-DM) was iteratively developed and tested using the benchmark dataset and compared with EndNote's default one step auto-deduplication process matching on ('author', 'year', 'title'). The accuracy of deduplication was reported by calculating the sensitivity and specificity. Further validation tests, with three additional benchmarked literature searches comprising a total of 4,563 citations were performed to determine the reliability of the SRA-DM algorithm. The sensitivity (84%) and specificity (100%) of the SRA-DM was superior to EndNote (sensitivity 51%, specificity 99.83%). Validation testing on three additional biomedical literature searches demonstrated that SRA-DM consistently achieved higher sensitivity than EndNote (90% vs 63%), (84% vs 73%) and (84% vs 64%). Furthermore, the specificity of SRA-DM was 100%, whereas the specificity of EndNote was imperfect (average 99.75%) with some unique records wrongly assigned as duplicates. Overall, there was a 42.86% increase in the number of duplicates records detected with SRA-DM compared with EndNote auto-deduplication. The Systematic Review Assistant-Deduplication Module offers users a reliable program to remove duplicate records with greater sensitivity

  2. Evaluation of Digital Model Accuracy and Time‑dependent ...

    African Journals Online (AJOL)

    Time‑dependent deformation of the alginate impressions and the accuracy of the conventional plaster models and digital models were evaluated separately. Results: Plaster models, negative and positive digital models showed significant differences in nearly all measurements at T (0), T (1), and T (2) times (P < 0.01, ...

  3. Performance and Dependability Evaluation: Successes, Failures and Challenges

    NARCIS (Netherlands)

    Haverkort, Boudewijn R.H.M.

    2008-01-01

    Over the last 40 years, the field of model-based performance and dependability evaluation has seen important developments, successes and scientific breakthroughs. However, the field has not matured into a key engineering discipline which is heavily called upon by computer system and software

  4. Efficient Move Evaluations for Time-Dependent Vehicle Routing Problems

    NARCIS (Netherlands)

    T.R. Visser (Thomas); R. Spliet (Remy)

    2017-01-01

    textabstractIn this paper we introduce several new methods for efficiently evaluating moves in neighborhood search heuristics for routing problems with time-dependent travel times. We consider both the case that route duration is constrained and the case that route duration appears in the objective.

  5. Anterior process calcaneal fractures: a systematic evaluation of associated conditions

    Energy Technology Data Exchange (ETDEWEB)

    Petrover, David [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Hopital Beaujon, Service de Radiologie, Paris (France); Schweitzer, Mark E. [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Laredo, J.D. [Hopital Lariboisiere, Service de Radiologie, Paris (France)

    2007-07-15

    The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

  6. Financial evaluations of antibiotic stewardship programs-a systematic review.

    Science.gov (United States)

    Dik, Jan-Willem H; Vemer, Pepijn; Friedrich, Alex W; Hendrix, Ron; Lo-Ten-Foe, Jerome R; Sinha, Bhanu; Postma, Maarten J

    2015-01-01

    There is an increasing awareness to counteract problems due to incorrect antimicrobial use. Interventions that are implemented are often part of an Antimicrobial Stewardship Program (ASPs). Studies publishing results from these interventions are increasing, including reports on the economical effects of ASPs. This review will look at the economical sections of these studies and the methods that were used. A systematic review was performed of articles found in the PubMed and EMBASE databases published from 2000 until November 2014. Included studies found were scored for various aspects and the quality of the papers was assessed following an appropriate check list (CHEC criteria list). 1233 studies were found, of which 149 were read completely. Ninety-nine were included in the final review. Of these studies, 57 only mentioned the costs associated with the antimicrobial medication. Others also included operational costs (n = 23), costs for hospital stay (n = 18), and/or other costs (n = 19). Nine studies were further assessed for their quality. These studies scored between 2 and 14 out of a potential total score of 19. This review gives an extensive overview of the current financial evaluation of ASPs and the quality of these economical studies. We show that there is still major potential to improve financial evaluations of ASPs. Studies do not use similar nor consistent methods or outcome measures, making it impossible draw sound conclusions and compare different studies. Finally, we make some recommendations for the future.

  7. Systematic study of doping dependence on linear magnetoresistance in p-PbTe

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, J. M.; Chitta, V. A.; Oliveira, N. F. [Instituto de Física, Universidade de São Paulo, São Paulo, PB 66318, São Paulo CEP 05315-970 (Brazil); Peres, M. L., E-mail: marcelos@unifei.edu.br; Castro, S. de; Soares, D. A. W. [Departamento de Física e Química, Universidade Federal de Itajubá, Itajubá, PB 50, Minas Gerais CEP 37500-903 (Brazil); Wiedmann, S.; Zeitler, U. [Radboud University Nijmegen, Institute for Molecules and Materials, High Field Magnet Laboratory, Toernooiveld 7, 6525 ED Nijmegen (Netherlands); Abramof, E.; Rappl, P. H. O.; Mengui, U. A. [Laboratório Associado de Sensores e Materiais, Instituto Nacional de Pesquisas Espaciais, São José dos Campos, PB 515, São Paulo CEP 12201-970 (Brazil)

    2014-10-20

    We report on a large linear magnetoresistance effect observed in doped p-PbTe films. While undoped p-PbTe reveals a sublinear magnetoresistance, p-PbTe films doped with BaF{sub 2} exhibit a transition to a nearly perfect linear magnetoresistance behaviour that is persistent up to 30 T. The linear magnetoresistance slope ΔR/ΔB is to a good approximation, independent of temperature. This is in agreement with the theory of Quantum Linear Magnetoresistance. We also performed magnetoresistance simulations using a classical model of linear magnetoresistance. We found that this model fails to explain the experimental data. A systematic study of the doping dependence reveals that the linear magnetoresistance response has a maximum for small BaF{sub 2} doping levels and diminishes rapidly for increasing doping levels. Exploiting the huge impact of doping on the linear magnetoresistance signal could lead to new classes of devices with giant magnetoresistance behavior.

  8. A systematic evaluation of the resource consumption of active pharmaceutical ingredient production at three different levels.

    Science.gov (United States)

    Van der Vorst, Geert; Dewulf, Jo; Aelterman, Wim; De Witte, Bruno; Van Langenhove, Herman

    2011-04-01

    In this paper, the development and the advantages of a methodology which allows the systematic assessment of the environmental impact on the resource side of specific pharmaceutical production processes with limited data entry is presented. The quantification of the process-specific mass and energy balances over three different system boundaries (process, gate-to-gate, and cradle-to-gate) is based on the methodology explained in Van der Vorst et al. (Ind. Eng. Chem. Res.2009, 48(11), 5344-5350). These mass and energy balances are now coupled with the thermodynamic term exergy allowing the quantification of the resource efficiency at the process and gate-to-gate level and the environmental impact at the cradle-to-gate level. The advantages of such a calculation tool for the resource evaluation are illustrated with five consecutive pharmaceutical production steps which are part of the galantamine (anti-Alzheimer medication) pathway. It is shown that such a quantitative and systematic evaluation tool allows a detailed and relatively fast evaluation of the resource efficiency of active pharmaceutical ingredient (API) production processes at the three different levels. Combining thermodynamics and the systematic data inventory methodology for the quantification of the resource efficiency first allows results to be merged into a single impact value (exergy loss/mol API or CEENE/mol API) for fast benchmarking and evaluation of different API production processes. Second, it also allows results to be divided over different categories depending on the users' interest and make thorough analysis of processes in order to pinpoint process improvements and quantitatively justify the introduction of second generation production processes or production techniques.

  9. A Systematic Review of Economic Evaluations of Pacemaker Telemonitoring Systems.

    Science.gov (United States)

    López-Villegas, Antonio; Catalán-Matamoros, Daniel; Martín-Saborido, Carlos; Villegas-Tripiana, Irene; Robles-Musso, Emilio

    2016-02-01

    Over the last decade, telemedicine applied to pacemaker monitoring has undergone extraordinary growth. It is not known if telemonitoring is more or less efficient than conventional monitoring. The aim of this study was to carry out a systematic review analyzing the available evidence on resource use and health outcomes in both follow-up modalities. We searched 11 databases and included studies published up until November 2014. The inclusion criteria were: a) experimental or observational design; b) studies based on complete economic evaluations; c) patients with pacemakers, and d) telemonitoring compared with conventional hospital monitoring. Seven studies met the inclusion criteria, providing information on 2852 patients, with a mean age of 81 years. The main indication for device implantation was atrioventricular block. With telemonitoring, cardiovascular events were detected and treated 2 months earlier than with conventional monitoring, thus reducing length of hospital stay by 34% and reducing routine and emergency hospital visits as well. There were no significant intergroup differences in perceived quality of life or number of adverse events. The cost of telemonitoring was 60% lower than that of conventional hospital monitoring. Compared with conventional monitoring, cardiovascular events were detected earlier and the number or hospitalizations and hospital visits was reduced with pacemaker telemonitoring. In addition, the costs associated with follow-up were lower with telemonitoring. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  10. Influenza vaccines in low and middle income countries A systematic review of economic evaluations

    NARCIS (Netherlands)

    Ott, Joerdis J.; Breteler, Janna Klein; Tam, John S.; Hutubessy, Raymond C. W.; Jit, Mark; de Boer, Michiel R.

    2013-01-01

    Objectives: Economic evaluations on influenza vaccination from low resource settings are scarce and have not been evaluated using a systematic approach. Our objective was to conduct a systematic review on the value for money of influenza vaccination in low- and middle-income countries.

  11. Systematic comparison of position and time dependent macroparticle simulations in beam dynamics studies

    Directory of Open Access Journals (Sweden)

    Ji Qiang

    2002-06-01

    Full Text Available Macroparticle simulation plays an important role in modern accelerator design and operation. Most linear rf accelerators have been designed based on macroparticle simulations using longitudinal position as the independent variable. In this paper, we have done a systematic comparison between using longitudinal position as the independent variable and using time as the independent variable in macroparticle simulations. We have found that, for an rms-matched beam, the maximum relative moment difference for second, fourth moments and beam maximum amplitudes between these two types of simulations is 0.25% in a 10 m reference transport system with physical parameters similar to the Spallation Neutron Source linac design. The maximum z-to- t transform error in the space-charge force calculation of the position dependent simulation is about 0.1% in such a system. This might cause a several percent error in a complete simulation of a linac with a length of hundreds of meters. Furthermore, the error may be several times larger in simulations of mismatched beams. However, if such errors are acceptable to the linac designer, then one is justified in using position dependent macroparticle simulations in this type of linac design application.

  12. Digital pathology: A systematic evaluation of the patent landscape.

    Science.gov (United States)

    Cucoranu, Ioan C; Parwani, Anil V; Vepa, Suryanarayana; Weinstein, Ronald S; Pantanowitz, Liron

    2014-01-01

    Digital pathology is a relatively new field. Inventors of technology in this field typically file for patents to protect their intellectual property. An understanding of the patent landscape is crucial for companies wishing to secure patent protection and market dominance for their products. To our knowledge, there has been no prior systematic review of patents related to digital pathology. Therefore, the aim of this study was to systematically identify and evaluate United States patents and patent applications related to digital pathology. Issued patents and patent applications related to digital pathology published in the United States Patent and Trademark Office (USPTO) database (www.uspto.gov) (through January 2014) were searched using the Google Patents search engine (Google Inc., Mountain View, California, USA). Keywords and phrases related to digital pathology, whole-slide imaging (WSI), image analysis, and telepathology were used to query the USPTO database. Data were downloaded and analyzed using the Papers application (Mekentosj BV, Aalsmeer, Netherlands). A total of 588 United States patents that pertain to digital pathology were identified. In addition, 228 patent applications were identified, including 155 that were pending, 65 abandoned, and eight rejected. Of the 588 patents granted, 348 (59.18%) were specific to pathology, while 240 (40.82%) included more general patents also usable outside of pathology. There were 70 (21.12%) patents specific to pathology and 57 (23.75%) more general patents that had expired. Over 120 unique entities (individual inventors, academic institutions, and private companies) applied for pathology specific patents. Patents dealt largely with telepathology and image analysis. WSI related patents addressed image acquisition (scanning and focus), quality (z-stacks), management (storage, retrieval, and transmission of WSI files), and viewing (graphical user interface (GUI), workflow, slide navigation and remote control). An

  13. Digital pathology: A systematic evaluation of the patent landscape

    Directory of Open Access Journals (Sweden)

    Ioan C. Cucoranu

    2014-01-01

    Full Text Available Introduction: Digital pathology is a relatively new field. Inventors of technology in this field typically file for patents to protect their intellectual property. An understanding of the patent landscape is crucial for companies wishing to secure patent protection and market dominance for their products. To our knowledge, there has been no prior systematic review of patents related to digital pathology. Therefore, the aim of this study was to systematically identify and evaluate United States patents and patent applications related to digital pathology. Materials and Methods: Issued patents and patent applications related to digital pathology published in the United States Patent and Trademark Office (USPTO database (www.uspto.gov (through January 2014 were searched using the Google Patents search engine (Google Inc., Mountain View, California, USA. Keywords and phrases related to digital pathology, whole-slide imaging (WSI, image analysis, and telepathology were used to query the USPTO database. Data were downloaded and analyzed using the Papers application (Mekentosj BV, Aalsmeer, Netherlands. Results: A total of 588 United States patents that pertain to digital pathology were identified. In addition, 228 patent applications were identified, including 155 that were pending, 65 abandoned, and eight rejected. Of the 588 patents granted, 348 (59.18% were specific to pathology, while 240 (40.82% included more general patents also usable outside of pathology. There were 70 (21.12% patents specific to pathology and 57 (23.75% more general patents that had expired. Over 120 unique entities (individual inventors, academic institutions, and private companies applied for pathology specific patents. Patents dealt largely with telepathology and image analysis. WSI related patents addressed image acquisition (scanning and focus, quality (z-stacks, management (storage, retrieval, and transmission of WSI files, and viewing (graphical user interface (GUI

  14. Digital pathology: A systematic evaluation of the patent landscape

    Science.gov (United States)

    Cucoranu, Ioan C.; Parwani, Anil V.; Vepa, Suryanarayana; Weinstein, Ronald S.; Pantanowitz, Liron

    2014-01-01

    Introduction: Digital pathology is a relatively new field. Inventors of technology in this field typically file for patents to protect their intellectual property. An understanding of the patent landscape is crucial for companies wishing to secure patent protection and market dominance for their products. To our knowledge, there has been no prior systematic review of patents related to digital pathology. Therefore, the aim of this study was to systematically identify and evaluate United States patents and patent applications related to digital pathology. Materials and Methods: Issued patents and patent applications related to digital pathology published in the United States Patent and Trademark Office (USPTO) database (www.uspto.gov) (through January 2014) were searched using the Google Patents search engine (Google Inc., Mountain View, California, USA). Keywords and phrases related to digital pathology, whole-slide imaging (WSI), image analysis, and telepathology were used to query the USPTO database. Data were downloaded and analyzed using the Papers application (Mekentosj BV, Aalsmeer, Netherlands). Results: A total of 588 United States patents that pertain to digital pathology were identified. In addition, 228 patent applications were identified, including 155 that were pending, 65 abandoned, and eight rejected. Of the 588 patents granted, 348 (59.18%) were specific to pathology, while 240 (40.82%) included more general patents also usable outside of pathology. There were 70 (21.12%) patents specific to pathology and 57 (23.75%) more general patents that had expired. Over 120 unique entities (individual inventors, academic institutions, and private companies) applied for pathology specific patents. Patents dealt largely with telepathology and image analysis. WSI related patents addressed image acquisition (scanning and focus), quality (z-stacks), management (storage, retrieval, and transmission of WSI files), and viewing (graphical user interface (GUI

  15. Evaluation of Stock Management Strategies Reliability at Dependent Demand

    Directory of Open Access Journals (Sweden)

    Lukinskiy Valery

    2017-03-01

    Full Text Available For efficiently increasing the logistic systems, the core specialists’ attention has to be directed to reducing costs and increasing supply chains reliability. A decent attention to costs reduction has already been paid, so it can be stated that in this way there is a significant progress. But the problem of reliability evaluation is still insufficiently explored, particularly, in such an important sphere as inventory management at the dependent demand.

  16. Annotation of the Evaluative Language in a Dependency Treebank

    Directory of Open Access Journals (Sweden)

    Šindlerová Jana

    2017-12-01

    Full Text Available In the paper, we present our efforts to annotate evaluative language in the Prague Dependency Treebank 2.0. The project is a follow-up of the series of annotations of small plaintext corpora. It uses automatic identification of potentially evaluative nodes through mapping a Czech subjectivity lexicon to syntactically annotated data. These nodes are then manually checked by an annotator and either dismissed as standing in a non-evaluative context, or confirmed as evaluative. In the latter case, information about the polarity orientation, the source and target of evaluation is added by the annotator. The annotations unveiled several advantages and disadvantages of the chosen framework. The advantages involve more structured and easy-to-handle environment for the annotator, visibility of syntactic patterning of the evaluative state, effective solving of discontinuous structures or a new perspective on the influence of good/bad news. The disadvantages include little capability of treating cases with evaluation spread among more syntactically connected nodes at once, little capability of treating metaphorical expressions, or disregarding the effects of negation and intensification in the current scheme.

  17. Performance Evaluation of Bluetooth Low Energy: A Systematic Review.

    Science.gov (United States)

    Tosi, Jacopo; Taffoni, Fabrizio; Santacatterina, Marco; Sannino, Roberto; Formica, Domenico

    2017-12-13

    Small, compact and embedded sensors are a pervasive technology in everyday life for a wide number of applications (e.g., wearable devices, domotics, e-health systems, etc.). In this context, wireless transmission plays a key role, and among available solutions, Bluetooth Low Energy (BLE) is gaining more and more popularity. BLE merges together good performance, low-energy consumption and widespread diffusion. The aim of this work is to review the main methodologies adopted to investigate BLE performance. The first part of this review is an in-depth description of the protocol, highlighting the main characteristics and implementation details. The second part reviews the state of the art on BLE characteristics and performance. In particular, we analyze throughput, maximum number of connectable sensors, power consumption, latency and maximum reachable range, with the aim to identify what are the current limits of BLE technology. The main results can be resumed as follows: throughput may theoretically reach the limit of ~230 kbps, but actual applications analyzed in this review show throughputs limited to ~100 kbps; the maximum reachable range is strictly dependent on the radio power, and it goes up to a few tens of meters; the maximum number of nodes in the network depends on connection parameters, on the network architecture and specific device characteristics, but it is usually lower than 10; power consumption and latency are largely modeled and analyzed and are strictly dependent on a huge number of parameters. Most of these characteristics are based on analytical models, but there is a need for rigorous experimental evaluations to understand the actual limits.

  18. Performance Evaluation of Bluetooth Low Energy: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Jacopo Tosi

    2017-12-01

    Full Text Available Small, compact and embedded sensors are a pervasive technology in everyday life for a wide number of applications (e.g., wearable devices, domotics, e-health systems, etc.. In this context, wireless transmission plays a key role, and among available solutions, Bluetooth Low Energy (BLE is gaining more and more popularity. BLE merges together good performance, low-energy consumption and widespread diffusion. The aim of this work is to review the main methodologies adopted to investigate BLE performance. The first part of this review is an in-depth description of the protocol, highlighting the main characteristics and implementation details. The second part reviews the state of the art on BLE characteristics and performance. In particular, we analyze throughput, maximum number of connectable sensors, power consumption, latency and maximum reachable range, with the aim to identify what are the current limits of BLE technology. The main results can be resumed as follows: throughput may theoretically reach the limit of ~230 kbps, but actual applications analyzed in this review show throughputs limited to ~100 kbps; the maximum reachable range is strictly dependent on the radio power, and it goes up to a few tens of meters; the maximum number of nodes in the network depends on connection parameters, on the network architecture and specific device characteristics, but it is usually lower than 10; power consumption and latency are largely modeled and analyzed and are strictly dependent on a huge number of parameters. Most of these characteristics are based on analytical models, but there is a need for rigorous experimental evaluations to understand the actual limits.

  19. Prevalence of Transgender Depends on the “Case” Definition: A Systematic Review

    Science.gov (United States)

    Collin, Lindsay; Reisner, Sari L.; Tangpricha, Vin; Goodman, Michael

    2016-01-01

    Background We conducted a systematic review and meta-analysis to evaluate how various definitions of “transgender” may affect prevalence estimates. Methods PubMed, Embase, and Medline were searched to identify studies reporting prevalence estimates of transgender in a population. All studies were grouped based on the case definition applied to the numerator. Summary estimates were derived using a random-effects model for total prevalence of transgender and for male-to-female (MTF) and female-to-male (FTM) subgroups. Overall and stratum-specific meta-prevalence estimates (mPs) and 95% confidence intervals (CIs) were accompanied by tests for heterogeneity, and meta-regressions to assess sources of heterogeneity. Results A total of 32 studies met the inclusion criteria for the systematic review. Of those, 27 studies provided necessary data for a meta-analysis. Overall mP (95% CI) per 100,000 population was 9.2 (4.9, 13.6) for surgical or hormonal gender affirmation therapy and 6.8 (4.6–9.1) for transgender-related diagnoses. Among studies assessing self-reported transgender identity, the mP was 871 (95% 519, 1224); however this result was influenced by a single outlier study. After removal of that study, the mP changed to 355 (95% CI 144, 566). Significant heterogeneity was observed in most analyses. Conclusions The empirical literature on the prevalence of transgender highlights the importance of adhering to specific case definitions because the results may range by orders of magnitude. Standardized and routine collection of transgender data is recommended. PMID:27045261

  20. Medication Reconciliation and Therapy Management in Dialysis-Dependent Patients: Need for a Systematic Approach

    Science.gov (United States)

    Cardone, Katie E.; Manley, Harold J.; St. Peter, Wendy L.; Shaffer, Rachel; Somers, Michael; Mehrotra, Rajnish

    2013-01-01

    Summary Patients with ESRD undergoing dialysis have highly complex medication regimens and disproportionately higher total cost of care compared with the general Medicare population. As shown by several studies, dialysis-dependent patients are at especially high risk for medication-related problems. Providing medication reconciliation and therapy management services is critically important to avoid costs associated with medication-related problems, such as adverse drug events and hospitalizations in the ESRD population. The Medicare Modernization Act of 2003 included an unfunded mandate stipulating that medication therapy management be offered to high-risk patients enrolled in Medicare Part D. Medication management services are distinct from the dispensing of medications and involve a complete medication review for all disease states. The dialysis facility is a logical coordination center for medication management services, like medication therapy management, and it is likely the first health care facility that a patient will present to after a care transition. A dedicated and adequately trained clinician, such as a pharmacist, is needed to provide consistent, high-quality medication management services. Medication reconciliation and medication management services that could consistently and systematically identify and resolve medication-related problems would be likely to improve ESRD patient outcomes and reduce total cost of care. Herein, this work provides a review of available evidence and recommendations for optimal delivery of medication management services to ESRD patients in a dialysis facility-centered model. PMID:23990162

  1. Systematic measurements of opacity dependence on temperature, density, and atomic number at stellar interior conditions

    Science.gov (United States)

    Nagayama, Taisuke

    2017-10-01

    Model predictions for iron opacity are notably different from measurements performed at matter conditions similar to the boundary between the solar radiation and convection zones. The calculated iron opacities have narrower spectral lines, weaker quasi-continuum at short wavelength, and deeper opacity windows than the measurements. If correct, these measurements help resolve a decade old problem in solar physics. A key question is therefore: What is responsible for the model-data discrepancy? The answer is complex because the experiments are challenging and opacity theories depend on multiple entangled physical processes such as the influence of completeness and accuracy of atomic states, line broadening, contributions from myriad transitions from excited states, and multi-photon absorption processes. To help determine the cause of this discrepancy, a systematic study of opacity variation with temperature, density, and atomic number is underway. Measurements of chromium, iron, and nickel opacities have been performed at two different temperatures and densities. The collection of measured opacities provides constraints on hypotheses to explain the discrepancy. We will discuss implications of measured opacities, experimental errors, and possible opacity model refinements. Sandia National Laboratories is a multi-mission laboratory managed and operated by National Technology and Engineering Solutions of Sandia, LLC., a wholly owned subsidiary of Honeywell International, Inc., for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-NA0003525.

  2. Effects of flaxseed and Hypericum perforatum on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women: a systematic review and meta-analysis.

    Science.gov (United States)

    Ghazanfarpour, Masumeh; Sadeghi, Ramin; Latifnejad Roudsari, Robab; Khadivzadeh, Talat; Khorsand, Imaneh; Afiat, Maliheh; Esmaeilizadeh, Mahdi

    2016-01-01

    In this study, we aimed at evaluation of the efficacy of Hypericum perforatum and flaxseed on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women. We searched MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials (RCT) to explore trials that assessed the effectiveness of H. perforatum and flaxseed on hot flash, vaginal atrophy and estrogen-dependent cancers. In this regard, the following terms were used "menopause AND H. perforatum OR flaxseed OR Linum usitatissimum. Only randomized controlled trials were included in the study. Nine RCTs were included in this systematic review. Based on the literature, flaxseed showed beneficial effect on hot flash frequency and intensity, which was not statistically significant. According to two trials, flaxseed showed estrogenic effects; however, no conclusion regarding cancer promoting or protecting effects can be made. The evidence of the efficacy of the flaxseed on alleviating vaginal atrophy was also limited due to inconsistent findings in this regard. One trial declared that Vitex agnus-castus and H. perforatum showed comparable decrease in the frequency of hot flashes. The results of our systematic review suggest beneficial effect on vasomotor symptom with both of flaxseed and H. perforatum. Consistent conclusion regarding estrogen-dependent cancers and maturation value is limited due to small number of trials related to flaxseed. Further trials are still needed to confirm the results of our systematic review.

  3. Understanding and evaluating systematic reviews and meta-analyses

    Directory of Open Access Journals (Sweden)

    Michael Bigby

    2014-01-01

    Full Text Available A systematic review is a summary of existing evidence that answers a specific clinical question, contains a thorough, unbiased search of the relevant literature, explicit criteria for assessing studies and structured presentation of the results. A systematic review that incorporates quantitative pooling of similar studies to produce an overall summary of treatment effects is a meta-analysis. A systematic review should have clear, focused clinical objectives containing four elements expressed through the acronym PICO ( Patient, group of patients, or problem, an Intervention, a Comparison intervention and specific O utcomes. Explicit and thorough search of the literature is a pre-requisite of any good systematic review. Reviews should have pre-defined explicit criteria for what studies would be included and the analysis should include only those studies that fit the inclusion criteria. The quality (risk of bias of the primary studies should be critically appraised. Particularly the role of publication and language bias should be acknowledged and addressed by the review, whenever possible. Structured reporting of the results with quantitative pooling of the data must be attempted, whenever appropriate. The review should include interpretation of the data, including implications for clinical practice and further research. Overall, the current quality of reporting of systematic reviews remains highly variable.

  4. A systematic review of health economic models of opioid agonist therapies in maintenance treatment of non-prescription opioid dependence.

    Science.gov (United States)

    Chetty, Mersha; Kenworthy, James J; Langham, Sue; Walker, Andrew; Dunlop, William C N

    2017-02-24

    Opioid dependence is a chronic condition with substantial health, economic and social costs. The study objective was to conduct a systematic review of published health-economic models of opioid agonist therapy for non-prescription opioid dependence, to review the different modelling approaches identified, and to inform future modelling studies. Literature searches were conducted in March 2015 in eight electronic databases, supplemented by hand-searching reference lists and searches on six National Health Technology Assessment Agency websites. Studies were included if they: investigated populations that were dependent on non-prescription opioids and were receiving opioid agonist or maintenance therapy; compared any pharmacological maintenance intervention with any other maintenance regimen (including placebo or no treatment); and were health-economic models of any type. A total of 18 unique models were included. These used a range of modelling approaches, including Markov models (n = 4), decision tree with Monte Carlo simulations (n = 3), decision analysis (n = 3), dynamic transmission models (n = 3), decision tree (n = 1), cohort simulation (n = 1), Bayesian (n = 1), and Monte Carlo simulations (n = 2). Time horizons ranged from 6 months to lifetime. The most common evaluation was cost-utility analysis reporting cost per quality-adjusted life-year (n = 11), followed by cost-effectiveness analysis (n = 4), budget-impact analysis/cost comparison (n = 2) and cost-benefit analysis (n = 1). Most studies took the healthcare provider's perspective. Only a few models included some wider societal costs, such as productivity loss or costs of drug-related crime, disorder and antisocial behaviour. Costs to individuals and impacts on family and social networks were not included in any model. A relatively small number of studies of varying quality were found. Strengths and weaknesses relating to model structure, inputs and approach were identified across

  5. Process variables in organizational stress management intervention evaluation research: a systematic review

    NARCIS (Netherlands)

    Havermans, B.M.; Schelvis, R.M.C.; Boot, C.R.L.; Brouwers, E.P.M.; Anema, J.R.; Beek, A.J. van der

    2016-01-01

    Objectives This systematic review aimed to explore which process variables are used in stress management intervention (SMI) evaluation research. Methods A systematic review was conducted using seven electronic databases. Studies were included if they reported on an SMI aimed at primary or secondary

  6. A systematic review evaluating the impact of task shifting on access ...

    African Journals Online (AJOL)

    A systematic review evaluating the impact of task shifting on access to antiretroviral therapy in sub-Saharan Africa. ... African Health Sciences ... Methods: A systematic search of the literature was undertaken, with both peer reviewed publications and conference abstracts presenting original data eligible for inclusion. Studies ...

  7. Can clinical evaluation predict return to sport after acute hamstring injuries? : a systematic review

    NARCIS (Netherlands)

    Schut, Lotte; Wangensteen, Arnlaug; Maaskant, Jolanda; Tol, Johannes L.; Bahr, Roald; Moen, Maarten

    2016-01-01

    BACKGROUND: The current literature on the value of clinical evaluation for predicting time to return to sport (RTS) after acute hamstring injuries has not been systematically summarised. OBJECTIVES: The aim of this study was to systematically review the literature on the prognostic value of clinical

  8. Evaluating interventions to improve somatic health in severe mental illness : a systematic review

    NARCIS (Netherlands)

    van Hasselt, F. M.; Krabbe, P. F. M.; van Ittersum, D. G.; Postma, M. J.; Loonen, A. J. M.

    2013-01-01

    OBJECTIVE: To present a systematic review of the evaluation of randomized interventions directed toward improving somatic health for patients with severe mental illness (SMI). METHOD: A systematic search in PubMed, Embase, Cinahl, and PsycInfo was performed. The scope of the search was prospective

  9. Process variables in organizational stress management intervention evaluation research : A systematic review

    NARCIS (Netherlands)

    Havermans, B.M.; Schlevis, Roosmarijn Mc; Boot, Cécile Rl; Brouwers, E.P.M.; Anema, Johannes R; van der Beek, Allard J

    2016-01-01

    OBJECTIVES: This systematic review aimed to explore which process variables are used in stress management intervention (SMI) evaluation research. METHODS: A systematic review was conducted using seven electronic databases. Studies were included if they reported on an SMI aimed at primary or

  10. A systematic review of economic evaluations of cardiac rehabilitation

    Directory of Open Access Journals (Sweden)

    Wong Wai

    2012-08-01

    Full Text Available Abstract Background Cardiac rehabilitation (CR, a multidisciplinary program consisting of exercise, risk factor modification and psychosocial intervention, forms an integral part of managing patients after myocardial infarction (MI, revascularization surgery and percutaneous coronary interventions, as well as patients with heart failure (HF. This systematic review seeks to examine the cost-effectiveness of CR for patients with MI or HF and inform policy makers in Singapore on published cost-effectiveness studies on CR. Methods Electronic databases (EMBASE, MEDLINE, NHS EED, PEDro, CINAHL were searched from inception to May 2010 for published economic studies. Additional references were identified through searching bibliographies of included studies. Two independent reviewers selected eligible publications based on the inclusion/exclusion criteria. Quality assessment of economic evaluations was undertaken using Drummond’s checklist. Results A total of 22 articles were selected for review. However five articles were further excluded because they were cost-minimization analyses, whilst one included patients with stroke. Of the final 16 articles, one article addressed both centre-based cardiac rehabilitation versus no rehabilitation, as well as home-based cardiac rehabilitation versus no rehabilitation. Therefore, nine studies compared cost-effectiveness between centre-based supervised CR and no CR; three studies examined that between centre- and home based CR; one between inpatient and outpatient CR; and four between home-based CR and no CR. These studies were characterized by differences in the study perspectives, economic study designs and time frames, as well as variability in clinical data and assumptions made on costs. Overall, the studies suggested that: (1 supervised centre-based CR was highly cost-effective and the dominant strategy when compared to no CR; (2 home-based CR was no different from centre-based CR; (3 no difference existed

  11. Systematic evaluation of social behaviour modelling with a single accelerometer

    NARCIS (Netherlands)

    Hung, H.; Englebienne, G.

    2013-01-01

    We describe our ongoing research on systematically analysing what types of socially related attributes and behaviours can be estimated automatically in highly social and crowded situations. This is a challenging task because obtaining the true labels for social behaviours or attributes in practice

  12. Effects of Ayahuasca and its Alkaloids on Drug Dependence: A Systematic Literature Review of Quantitative Studies in Animals and Humans.

    Science.gov (United States)

    Nunes, Amanda A; Dos Santos, Rafael G; Osório, Flávia L; Sanches, Rafael F; Crippa, José Alexandre S; Hallak, Jaime E C

    2016-01-01

    Recently, the anti-addictive potential of ayahuasca, a dimethyltryptamine(DMT)- and β-carboline-rich hallucinogenic beverage traditionally used by indigenous groups of the Northwest Amazon and currently by syncretic churches worldwide, has received increased attention. To better evaluate this topic, we performed a systematic literature review using the PubMed database to find quantitative studies (using statistical analysis) that assessed the effects of ayahuasca or its components in drug-related symptoms or disorders. We found five animal studies (using harmaline, harmine, or ayahuasca) and five observational studies of regular ayahuasca consumers. All animal studies showed improvement of biochemical or behavioral parameters related to drug-induced disorders. Of the five human studies, four reported significant reductions of dependence symptoms or substance use, while one did not report significant results. The mechanisms responsible for the anti-addictive properties of ayahuasca and its alkaloids are not clarified, apparently involving both peripheral MAO-A inhibition by the β-carbolines and central agonism of DMT at 5-HT2A receptors expressed in brain regions related to the regulation of mood and emotions. Although results are promising, controlled studies are needed to replicate these preliminary findings.

  13. A systematic review of factors influencing student ratings in undergraduate medical education course evaluations.

    Science.gov (United States)

    Schiekirka, Sarah; Raupach, Tobias

    2015-03-05

    Student ratings are a popular source of course evaluations in undergraduate medical education. Data on the reliability and validity of such ratings have mostly been derived from studies unrelated to medical education. Since medical education differs considerably from other higher education settings, an analysis of factors influencing overall student ratings with a specific focus on medical education was needed. For the purpose of this systematic review, online databases (PubMed, PsycInfo and Web of Science) were searched up to August 1st, 2013. Original research articles on the use of student ratings in course evaluations in undergraduate medical education were eligible for inclusion. Included studies considered the format of evaluation tools and assessed the association of independent and dependent (i.e., overall course ratings) variables. Inclusion and exclusion criteria were checked by two independent reviewers, and results were synthesised in a narrative review. Twenty-five studies met the inclusion criteria. Qualitative research (2 studies) indicated that overall course ratings are mainly influenced by student satisfaction with teaching and exam difficulty rather than objective determinants of high quality teaching. Quantitative research (23 studies) yielded various influencing factors related to four categories: student characteristics, exposure to teaching, satisfaction with examinations and the evaluation process itself. Female gender, greater initial interest in course content, higher exam scores and higher satisfaction with exams were associated with more positive overall course ratings. Due to the heterogeneity and methodological limitations of included studies, results must be interpreted with caution. Medical educators need to be aware of various influences on student ratings when developing data collection instruments and interpreting evaluation results. More research into the reliability and validity of overall course ratings as typically used in the

  14. A systematic evaluation of Schwann cell injection into acellular cold-preserved nerve grafts.

    Science.gov (United States)

    Jesuraj, Nithya J; Santosa, Katherine B; Newton, Piyaraj; Liu, Z; Hunter, Daniel A; Mackinnon, Susan E; Sakiyama-Elbert, Shelly E; Johnson, Philip J

    2011-04-30

    Peripheral nerve regeneration after injury depends on environmental cues and trophic support. Schwann cells (SCs) secrete trophic factors that promote neuronal survival and help guide axons during regeneration. The addition of SCs to acellular nerve grafts is a promising strategy for enhancing peripheral nerve regeneration; however, inconsistencies in seeding parameters have led to varying results. The current work sought to establish a systematic approach to seeding SCs in cold-preserved acellular nerve grafts. Studies were undertaken to (1) determine the needle gauge for optimal cell survival and minimal epineurial disruption during injection, (2) track the seeded SCs using a commercially available dye, and (3) evaluate the seeding efficiency of SCs in nerve grafts. It was determined that seeding with a 27-gauge needle resulted in the highest viability of SCs with the least damage to the epineurium. In addition, Qtracker(®) dye, a commercially available quantum dot nanocrystal, was used to label SCs prior to transplantation, which allowed visualization of the seeded SCs in nerve grafts. Finally, stereological methods were used to evaluate the seeding efficiency of SCs in nerve grafts immediately after injection and following a 1- or 3-day in vitro incubation in SC growth media. Using a systematic approach, the best needle gauge and a suitable dye for SC visualization in acellular nerve grafts were identified. Seeding efficiency in these grafts was also determined. The findings will lead to improvements ability to assess injection of cells (including SCs) for use with acellular nerve grafts to promote nerve regeneration. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. Systematic Differences across Evaluation Schemes and Educational Choice

    DEFF Research Database (Denmark)

    Rangvid, Beatrice Schindler

    consequential in a school system like the Danish, where post-compulsory education choices are made on ability signals only from teacher scores, as external assessments are not available until after these choices are made. I document that educationally disadvantaged groups (boys, low-SES, and migrant pupils......) receive systematically lower teacher scores for equal exam scores than their advantaged peers. Using sibling fixed effects methods, I then simulate changes in educational choices for disadvantaged groups were they graded by their teachers as their advantaged peers. The results show an increase in low...

  16. Frequency Dependence Hearing Loss Evaluation in Perforated Tympanic Membrane.

    Science.gov (United States)

    Dawood, Mohammed Radef

    2017-10-01

    Introduction  Tympanic membrane perforation is a relatively common problem that predisposes patients to varying degrees of conductive hearing loss. Objective  The objective of this study is to evaluate and analyze the frequency dependence hearing loss in tympanic membrane perforation based on the size and the site of perforation. Methods  For the study, I selected 71 patients' (89) ears for the cross-sectional study with tympanic membrane perforations; I examined the size and the site of perforations under the microscope and classified them into small, moderate, large, and subtotal perforations, and into anterior central, posterior central, malleolor central, and big central perforations. I measured mean level of speech frequencies hearing loss, and its relation with the site and the size of the perforation analyzed. Results  The mean hearing loss at different sizes of the perforation at all speech frequencies was 37.4 dB, with ABG of 26.6 dB, and its maximum loss was detected in subtotal perforation of 42.3 dB, with ABG of 33.7 dB, at 500 Hz frequency, while in relation to the sites, it was 38.2 dB, with ABG of 26.8 dB, and its maximum loss was detected in big central site perforation of 42.1 dB, with ABG of 33.6 dB, at 500 Hz frequency. Conclusions  The hearing loss was proportionally related with the sizes of the perforations, and the posterior site had greater impact on the hearing than anterior site perforations. This was also applied to the frequency dependence hearing level, as was detected to be worse at lower frequencies as 500 Hz, than those of 1000-2000 Hz.

  17. Systematic Evaluation of Uncertainty in Material Flow Analysis

    DEFF Research Database (Denmark)

    Laner, David; Rechberger, Helmut; Astrup, Thomas Fruergaard

    2014-01-01

    Material flow analysis (MFA) is a tool to investigate material flows and stocks in defined systems as a basis for resource management or environmental pollution control. Because of the diverse nature of sources and the varying quality and availability of data, MFA results are inherently uncertain...... in MFA. Based on this, recommendations for consideration of uncertainty in MFA are provided. A five-step framework for uncertainty handling is outlined, reflecting aspects such as data quality and goal/scope of the MFA. We distinguish between descriptive (quantification of material turnover in a region...... for exploratory MFAs. Irrespective of the level of sophistication, lack of information about MFA data poses a major challenge for meaningful uncertainty analysis. The step-wise framework suggested here provides a systematic way to consider available information and produce results as precise as the data warrant....

  18. Evaluating clinical ethics support in mental healthcare: a systematic literature review.

    NARCIS (Netherlands)

    Hem, M.H.; Pedersen, R.; Norvoll, R.; Molewijk, A.C.

    2015-01-01

    A systematic literature review on evaluation of clinical ethics support services in mental healthcare is presented and discussed. The focus was on (a) forms of clinical ethics support services, (b) evaluation of clinical ethics support services, (c) contexts and participants and (d) results. Five

  19. Design and Systematic Evaluation of the Freshman Athlete Scholastic Training Program.

    Science.gov (United States)

    Harney, M. K.; And Others

    1986-01-01

    Developed and systematically evaluated a prototype set of procedures called the Freshman Athlete Scholastic Training (FAST) program. Describes the design of this applied program and evaluates its efficacy in improving the academic performance of freshman student athletes, male and female, from a variety of athletic programs. The FAST program…

  20. Systematic narrative review of decision frameworks to select the appropriate modelling approaches for health economic evaluations.

    Science.gov (United States)

    Tsoi, B; O'Reilly, D; Jegathisawaran, J; Tarride, J-E; Blackhouse, G; Goeree, R

    2015-06-17

    In constructing or appraising a health economic model, an early consideration is whether the modelling approach selected is appropriate for the given decision problem. Frameworks and taxonomies that distinguish between modelling approaches can help make this decision more systematic and this study aims to identify and compare the decision frameworks proposed to date on this topic area. A systematic review was conducted to identify frameworks from peer-reviewed and grey literature sources. The following databases were searched: OVID Medline and EMBASE; Wiley's Cochrane Library and Health Economic Evaluation Database; PubMed; and ProQuest. Eight decision frameworks were identified, each focused on a different set of modelling approaches and employing a different collection of selection criterion. The selection criteria can be categorized as either: (i) structural features (i.e. technical elements that are factual in nature) or (ii) practical considerations (i.e. context-dependent attributes). The most commonly mentioned structural features were population resolution (i.e. aggregate vs. individual) and interactivity (i.e. static vs. dynamic). Furthermore, understanding the needs of the end-users and stakeholders was frequently incorporated as a criterion within these frameworks. There is presently no universally-accepted framework for selecting an economic modelling approach. Rather, each highlights different criteria that may be of importance when determining whether a modelling approach is appropriate. Further discussion is thus necessary as the modelling approach selected will impact the validity of the underlying economic model and have downstream implications on its efficiency, transparency and relevance to decision-makers.

  1. Evaluation of Time-Dependent Behavior of Soils

    DEFF Research Database (Denmark)

    Augustesen, Anders; Liingaard, Morten; Lade, Poul V.

    2004-01-01

    The time-dependent behavior of soils has been investigated extensively through one-dimensional and triaxial test conditions. Most of the observations in literature have focused on the determination of the time-dependent behavior of clayey soils, whereas the reported experimental studies of granular...

  2. Evaluation and Treatment of Pericarditis: A Systematic Review.

    Science.gov (United States)

    Imazio, Massimo; Gaita, Fiorenzo; LeWinter, Martin

    2015-10-13

    Pericarditis is the most common form of pericardial disease and a relatively common cause of chest pain. To summarize published evidence on the causes, diagnosis, therapy, prevention, and prognosis of pericarditis. A literature search of BioMedCentral, Google Scholar, MEDLINE, Scopus, and the Cochrane Database of Systematic Reviews was performed for human studies without language restriction from January 1, 1990, to August 31, 2015. After literature review and selection of meta-analyses, randomized clinical trials, and large observational studies, 30 studies (5 meta-analyses, 10 randomized clinical trials, and 16 cohort studies) with 7569 adult patients were selected for inclusion. The etiology of pericarditis may be infectious (eg, viral and bacterial) or noninfectious (eg, systemic inflammatory diseases, cancer, and post-cardiac injury syndromes). Tuberculosis is a major cause of pericarditis in developing countries but accounts for less than 5% of cases in developed countries, where idiopathic, presumed viral causes are responsible for 80% to 90% of cases. The diagnosis is based on clinical criteria including chest pain, a pericardial rub, electrocardiographic changes, and pericardial effusion. Certain features at presentation (temperature >38°C [>100.4°F], subacute course, large effusion or tamponade, and failure of nonsteroidal anti-inflammatory drug [NSAID] treatment) indicate a poorer prognosis and identify patients requiring hospital admission. The most common treatment for idiopathic and viral pericarditis in North America and Europe is NSAID therapy. Adjunctive colchicine can ameliorate the initial episode and is associated with approximately 50% lower recurrence rates. Corticosteroids are a second-line therapy for those who do not respond, are intolerant, or have contraindications to NSAIDs and colchicine. Recurrences may occur in 30% of patients without preventive therapy. Pericarditis is the most common form of pericardial disease worldwide and may

  3. Effects of flaxseed and Hypericum perforatum on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Masumeh Ghazanfarpour

    2016-04-01

    Conclusion: The results of our systematic review suggest beneficial effect on vasomotor symptom with both of flaxseed and H. perforatum. Consistent conclusion regarding estrogen-dependent cancers and maturation value is limited due to small number of trials related to flaxseed. Further trials are still needed to confirm the results of our systematic review.

  4. Clinical evaluation of balance in hemiparetic adults: a systematic review

    Directory of Open Access Journals (Sweden)

    Carla Bambirra

    Full Text Available Introduction Hemiparesis is a common post-stroke impairment often associated with balance deficits. Standardized instruments for balance assessment may be useful in identifying individuals at risk of falling and evaluating intervention outcomes. Objectives To identify instruments with adequate psychometric properties and clinical application to assess balance in hemiparetic cases within the scope of physiotherapy and to verify tools most frequently used in studies that evaluated the effects of therapeutic interventions in order to improve the balance of hemiparetic patients. Methods A search was conducted in the Medline, Lilacs, PEDro, and Web of Science databases by two independent researchers, who selected and analyzed studies that evaluated the reliability and validity of balance assessment instruments and intervention results. Results and discussion The Berg Balance Scale was the most frequently used instrument in the intervention studies. Nine single-task tests (timed up and go, functional reach test, step test, four-square step test, side step test, supported standing balance, standing arm raise, static tandem standing, and weight shifting and six multiple-task tests (Berg balance scale, Brunel balance assessment, Fugl-Meyer Assessment/balance section, mini balance evaluation systems test, and postural assessment scale for stroke patients demonstrated adequate psychometric properties and clinical applications to assess balance in hemiparetic individuals. Conclusions The Berg Balance Scale had the most widely studied psychometric properties and was the most frequently used scale in the intervention studies. Further studies are required to validate and adapt other instruments for the Brazilian population.

  5. Evaluating nicotine dependence levels in e-cigarette users.

    Science.gov (United States)

    González Roz, Alba; Secades Villa, Roberto; Weidberg, Sara

    2017-01-11

    Despite the fact that electronic cigarettes (e-cigarettes) are rapidly growing in popularity and use worldwide, there is scarce scientific data on abuse liability among e-cigarette users, and about whether e-cigarette use is related to nicotine dependence or not. The aim of this study is to explore nicotine dependence levels in a sample of experienced e-cigarette users (n= 39) and to compare them with current tobacco cigarette smokers (n=42). We conducted several face-to-face interviews in order to assess sociodemographic and dependence related characteristics in both e-cigarette users and in smokers. Adapted versions of both the Fagerström test for nicotine dependence (FTND) and the nicotine dependence syndrome scale (NDSS) were used to analyze nicotine dependence in each of the groups. Biochemical markers of carbon monoxide and urinary cotinine analysis were also collected. Results showed that e-cigarette users scored lower than cigarette smokers in both FTND and all NDSS subscales. Our findings extend previous research on e-cigarette use and nicotine addiction and suggest that e-cigarette users are less dependent on nicotine than current tobacco cigarette smokers. Further prospective studies are needed to better ascertain their addictiveness potential, comparing those smokers who switched to e-cigarettes from smoking cigarettes, and those who had never been tobacco cigarette smokers.

  6. Systematic evaluation of photodetector performance for plastic scintillation dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Boivin, Jonathan, E-mail: jonathan.boivin.1@ulaval.ca; Beaulieu, Luc [Département de Physique, de Génie physique et d’Optique, et Centre de recherche sur le cancer, Université Laval, Québec, Québec G1V 0A6, Canada and Département de Radio-Oncologie et Axe oncologie du Centre de recherche du CHU de Québec, CHU de Québec, Québec, Québec G1R 2J6 (Canada); Beddar, Sam [Department of Radiation Physics, University of Texas, MD Anderson Cancer Center, Houston, Texas 77030 (United States); Guillemette, Maxime [Département de Physique, de Génie physique et d’Optique, Université Laval, Québec, Québec G1V 0A6, Canada and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Québec G1V 4G5 (Canada)

    2015-11-15

    Purpose: The authors’ objective was to systematically assess the performance of seven photodetectors used in plastic scintillation dosimetry. The authors also propose some guidelines for selecting an appropriate detector for a specific application. Methods: The plastic scintillation detector (PSD) consisted of a 1-mm diameter, 10-mm long plastic scintillation fiber (BCF-60), which was optically coupled to a clear 10-m long optical fiber of the same diameter. A light-tight plastic sheath covered both fibers and the scintillator end was sealed. The clear fiber end was connected to one of the following photodetectors: two polychromatic cameras (one with an optical lens and one with a fiber optic taper replacing the lens), a monochromatic camera with an optical lens, a PIN photodiode, an avalanche photodiode (APD), or a photomultiplier tube (PMT). A commercially available W1 PSD was also included in the study, but it relied on its own fiber and scintillator. Each PSD was exposed to both low-energy beams (120, 180, and 220 kVp) from an orthovoltage unit and high-energy beams (6 and 23 MV) from a linear accelerator. Various dose rates were tested to identify the operating range and accuracy of each photodetector. Results: For all photodetectors, the relative uncertainty was less than 5% for dose rates higher than 3 mGy/s. The cameras allowed multiple probes to be used simultaneously, but they are less sensitive to low-light signals. The PIN, APD, and PMT had higher sensitivity, making them more suitable for low dose rate and out-of-field dose monitoring. The relative uncertainty of the PMT was less than 1% at the lowest dose rate achieved (0.10 mGy/s), suggesting that it was optimal for use in live dosimetry. Conclusions: For dose rates higher than 3 mGy/s, the PIN diode is the most effective photodetector in terms of performance/cost ratio. For lower dose rates, such as those seen in interventional radiology or high-gradient radiotherapy, PMTs are the optimal choice.

  7. Systematic evaluation of photodetector performance for plastic scintillation dosimetry.

    Science.gov (United States)

    Boivin, Jonathan; Beddar, Sam; Guillemette, Maxime; Beaulieu, Luc

    2015-11-01

    The authors' objective was to systematically assess the performance of seven photodetectors used in plastic scintillation dosimetry. The authors also propose some guidelines for selecting an appropriate detector for a specific application. The plastic scintillation detector (PSD) consisted of a 1-mm diameter, 10-mm long plastic scintillation fiber (BCF-60), which was optically coupled to a clear 10-m long optical fiber of the same diameter. A light-tight plastic sheath covered both fibers and the scintillator end was sealed. The clear fiber end was connected to one of the following photodetectors: two polychromatic cameras (one with an optical lens and one with a fiber optic taper replacing the lens), a monochromatic camera with an optical lens, a PIN photodiode, an avalanche photodiode (APD), or a photomultiplier tube (PMT). A commercially available W1 PSD was also included in the study, but it relied on its own fiber and scintillator. Each PSD was exposed to both low-energy beams (120, 180, and 220 kVp) from an orthovoltage unit and high-energy beams (6 and 23 MV) from a linear accelerator. Various dose rates were tested to identify the operating range and accuracy of each photodetector. For all photodetectors, the relative uncertainty was less than 5% for dose rates higher than 3 mGy/s. The cameras allowed multiple probes to be used simultaneously, but they are less sensitive to low-light signals. The PIN, APD, and PMT had higher sensitivity, making them more suitable for low dose rate and out-of-field dose monitoring. The relative uncertainty of the PMT was less than 1% at the lowest dose rate achieved (0.10 mGy/s), suggesting that it was optimal for use in live dosimetry. For dose rates higher than 3 mGy/s, the PIN diode is the most effective photodetector in terms of performance/cost ratio. For lower dose rates, such as those seen in interventional radiology or high-gradient radiotherapy, PMTs are the optimal choice.

  8. A systematic review of COTS evaluation and selection approaches

    Directory of Open Access Journals (Sweden)

    Rakesh Garg

    2017-11-01

    Full Text Available In the past decades, a number of researchers have made their significant contributions to develop different approaches for solving a very challenging problem of commercial off-the shelf (COTS selection. The development of software with high quality and minimum development time has always been a difficult job for the software developers. Therefore, in today’s scenario, software developers move towards the implementation of component based software engineering that relies on the integration of small pieces of code namely (COTS. In this study, we present a comprehensive descriptive explanation of the various COTS evaluation and selection approaches developed by various researchers in the past to understand the concept of COTS selection. The advantages and disadvantages of each COTS selection approach are also provided, which will give a better prospect to the readers to understand the various existing COTS evaluation and selection approaches.

  9. A Systematic Evaluation of Analogs for the Read-across ...

    Science.gov (United States)

    Read-across is a data gap filling technique widely used within category and analog approaches to predict a biological property for a target data-poor chemical using known information from similar (source analog) chemical(s). Potential source analogs are typically identified based on structural similarity. Although much guidance has been published for read-across, practical guiding principles for the identification and evaluation of the scientific validity of source analogs, which is a critical step in deriving a robust read-across prediction, remains largely lacking.This case study explores the extent to which 3 structure descriptor sets (Pubchem, Chemotyper and MoSS) and their combinations are able to identify valid analogs for reading across Estrogen Receptor (ER) activity for a specific class of chemicals: hindered phenols. For each target chemical, two sets of analogs (hindered and non-hindered phenols) were selected using each descriptor set with two cut-offs: (1). Minimum Tanimoto similarity (range 0.1 - 0.9), and (2). Closest N analogs (range 1 - 10). Each target-analog pair was then evaluated for its agreement with measured ER binding and agonism. Subsequently, the analogs were filtered using physchem properties (LogKow & Molecular Volume) and the resultant agreement between each target-analog pair was evaluated. The data set comprised 462 hindered phenols and 296 non-hindered phenols. The results demonstrate that: (1). The concordance in ER activity r

  10. User Experience Evaluations in Rehabilitation Video Games for Children: A Systematic Mapping of the Literature.

    Science.gov (United States)

    Rico-Olarte, Carolina; López, Diego M; Blobel, Bernd; Kepplinger, Sara

    2017-01-01

    In recent years, the interest in user experience (UX) evaluation methods for assessing technology solutions, especially in health systems for children with special needs like cognitive disabilities, has increased. Conduct a systematic mapping study to provide an overview in the field of UX evaluations in rehabilitation video games for children. The definition of research questions, the search for primary studies and the extraction of those studies by inclusion and exclusion criteria lead to the mapping of primary papers according to a classification scheme. Main findings from this study include the detection of the target population of the selected studies, the recognition of two different ways of evaluating UX: (i) user evaluation and (ii) system evaluation, and UX measurements and devices used. This systematic mapping specifies the research gaps identified for future research works in the area.

  11. The equity dimension in evaluations of the quality and outcomes framework: a systematic review.

    Science.gov (United States)

    Boeckxstaens, Pauline; Smedt, Delphine De; Maeseneer, Jan De; Annemans, Lieven; Willems, Sara

    2011-08-31

    Pay-for-performance systems raise concerns regarding inequity in health care because providers might select patients for whom targets can easily be reached. This paper aims to describe the evolution of pre-existing (in)equity in health care in the period after the introduction of the Quality and Outcomes Framework (QOF) in the UK and to describe (in)equities in exception reporting. In this evaluation, a theory-based framework conceptualising equity in terms of equal access, equal treatment and equal treatment outcomes for people in equal need is used to guide the work. A systematic MEDLINE and Econlit search identified 317 studies. Of these, 290 were excluded because they were not related to the evaluation of QOF, they lacked an equity dimension in the evaluation, their qualitative research focused on experiences or on the nature of the consultation, or unsuitable methodology was used to pronounce upon equity after the introduction of QOF. None of the publications (n = 27) assessed equity in access to health care. Concerning equity in treatment and (intermediate) treatment outcomes, overall quality scores generally improved. For the majority of the observed indicators, all citizens benefit from this improvement, yet the extent to which different patient groups benefit tends to vary and to be highly dependent on the type and complexity of the indicator(s) under study, the observed patient group(s) and the characteristics of the study. In general, the introduction of QOF was favourable for the aged and for males. Total QOF scores did not seem to vary according to ethnicity. For deprivation, small but significant residual differences were observed after the introduction of QOF favouring less deprived groups. These differences are mainly due to differences at the practice level. The variance in exception reporting according to gender and socio-economic position is low. Although QOF seems not to be socially selective at first glance, this does not mean QOF does not

  12. Methods for systematic reviews of health economic evaluations: a systematic review, comparison, and synthesis of method literature.

    Science.gov (United States)

    Mathes, Tim; Walgenbach, Maren; Antoine, Sunya-Lee; Pieper, Dawid; Eikermann, Michaela

    2014-10-01

    The quality of systematic reviews of health economic evaluations (SR-HE) is often limited because of methodological shortcomings. One reason for this poor quality is that there are no established standards for the preparation of SR-HE. The objective of this study is to compare existing methods and suggest best practices for the preparation of SR-HE. To identify the relevant methodological literature on SR-HE, a systematic literature search was performed in Embase, Medline, the National Health System Economic Evaluation Database, the Health Technology Assessment Database, and the Cochrane methodology register, and webpages of international health technology assessment agencies were searched. The study selection was performed independently by 2 reviewers. Data were extracted by one reviewer and verified by a second reviewer. On the basis of the overlaps in the recommendations for the methods of SR-HE in the included papers, suggestions for best practices for the preparation of SR-HE were developed. Nineteen relevant publications were identified. The recommendations within them often differed. However, for most process steps there was some overlap between recommendations for the methods of preparation. The overlaps were taken as basis on which to develop suggestions for the following process steps of preparation: defining the research question, developing eligibility criteria, conducting a literature search, selecting studies, assessing the methodological study quality, assessing transferability, and synthesizing data. The differences in the proposed recommendations are not always explainable by the focus on certain evaluation types, target audiences, or integration in the decision process. Currently, there seem to be no standard methods for the preparation of SR-HE. The suggestions presented here can contribute to the harmonization of methods for the preparation of SR-HE. © The Author(s) 2014.

  13. A Systematic Evaluation of Analogs and Automated Read ...

    Science.gov (United States)

    Read-across is a data gap filling technique widely used within category and analog approaches to predict a biological property for a data-poor (target) chemical using known information from similar (source analog) chemical(s). Potential source analogs are typically identified based on structural similarity. Although much guidance has been published for read-across, practical principles for the identification and evaluation of the scientific validity of source analogs remains lacking. This case study explores how well 3 structure descriptor sets (Pubchem, Chemotyper and MoSS) are able to identify analogs for read-across and predict Estrogen Receptor (ER) binding activity for a specific class of chemicals: hindered phenols. For each target chemical, analogs were selected using each descriptor set with two cut-offs: (1) Minimum Tanimoto similarity (range 0.1 - 0.9), and (2) Closest N analogs (range 1 - 10). Each target-analog pair was then evaluated for its agreement with measured ER binding and agonism. The analogs were subsequently filtered using: (1) physchem properties (LogKow & Molecular Volume), and (2) number of literature sources as a marker for the quality of the experimental data. A majority vote prediction was made for each target phenol by reading-across from the closest N analogs. The data set comprised 462 hindered phenols and 257 non-hindered phenols. The results demonstrate that: (1) The concordance in ER activity rises with increasing similarity,

  14. Dependability and Survivability Evaluation of a Water Distribution Process with Arcade

    NARCIS (Netherlands)

    Roolvink, S.; Remke, Anne Katharina Ingrid; Stoelinga, Mariëlle Ida Antoinette

    2009-01-01

    Among others, drinking water belongs to the socalled critical infrastructures. To ensure that the water production meets current and future societal needs, a systematic and rigorous analysis is needed. In this paper, we report our ��?rst experience with dependability analysis of the last phase of a

  15. Reactive endplate marrow changes: a systematic morphologic and epidemiologic evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Karchevsky, Michael [Hahnemann University Hospital, Department of Radiology, Philadelphia (United States); Thomas Jefferson University Hospital, Department of Radiology, Philadelphia (United States); Schweitzer, Mark E. [Hospital for Joint Diseases, Department of Radiology, New York (United States); Carrino, John A.; Zoga, Adam; Montgomery, Douglas; Parker, Laurence [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia (United States)

    2005-03-01

    To evaluate the morphology and location of vertebral endplate changes, and to analyze their association with age, gender, and body mass index (BMI). At 1.5 T (T1-weighted, T2-weighted/STIR) 100 lumbar spines were evaluated separately by three observers. The readers classified the endplate bone marrow abnormalities on sagittal MR images according to the definitions of Modic et al. Findings were localized by disc segment; whether in the upper and/or lower endplate; and within each endplate divided into 15 segments. Disc space narrowing, as well as disc desiccation, was also noted at each vertebral level. In addition, endplate changes were correlated with age, gender, and BMI (weight(kg)/height(m){sup 2}). A total of 15,000 data points were studied and 422 total changes recorded. A total of 99 vertebral levels were affected in 58 patients. Of these, 171 were of type I, 242 were of type II, and 9 were of type III. L4 - L5 and L5 - S1 vertebral levels were most commonly involved, having (142, 4.73%) and (116, 3.87%) changes respectively (P<0.0001). The upper and lower aspects of the endplate were affected similarly. Changes most frequently occurred at the anterior aspect of the endplate (P<0.0001). Endplate marrow changes were associated with increasing age (P<0.0001) and, surprisingly, male gender (P<0.0001). Endplate changes were not associated with BMI. The fatty pattern was most common, with the sclerotic pattern being rare. Endplate marrow changes most often occurred at the anterior aspect of the endplate, particularly at L4 - L5 and L5 - S1 levels. Modic changes occur more frequently with aging, evidence of their degenerative etiology. They were, however, not related to body habitus, but to weight and male gender. (orig.)

  16. A Systematic Evaluation of Token Economies as a Classroom Management Tool for Students with Challenging Behavior

    Science.gov (United States)

    Maggin, Daniel M.; Chafouleas, Sandra M.; Goddard, Katelyn M.; Johnson, Austin H.

    2011-01-01

    A two-part systematic review was undertaken to assess the effectiveness of token economies in increasing rates of appropriate classroom behavior for students demonstrating behavioral difficulties. The first part of the review utilized the recently published What Works Clearinghouse (WWC) standards for evaluating single-subject research to…

  17. Evaluating the Validity of Systematic Reviews to Identify Empirically Supported Treatments

    Science.gov (United States)

    Slocum, Timothy A.; Detrich, Ronnie; Spencer, Trina D.

    2012-01-01

    The "best available evidence" is one of the three basic inputs into evidence-based practice. This paper sets out a framework for evaluating the quality of systematic reviews that are intended to identify empirically supported interventions as a way of summarizing the best available evidence. The premise of this paper is that the process of…

  18. Systematic Evaluation of Methods for Integration of Transcriptomic Data into Constraint-Based Models of Metabolism

    DEFF Research Database (Denmark)

    Machado, Daniel; Herrgard, Markus

    2014-01-01

    is then systematically evaluated using published data from three different case studies in E. coli and S. cerevisiae. The flux predictions made by different methods using transcriptomic data are compared against experimentally determined extracellular and intracellular fluxes (from 13C-labeling data). The sensitivity...... biological principles of metabolic regulation....

  19. Economic evaluations of hepatitis B vaccination strategies - A systematic review of the literature

    NARCIS (Netherlands)

    Wit GA de; Welte R; CZO

    National and international economic evaluations of universal vaccination against hepatitis B were systematically selected from the literature. Only the studies meeting the following criteria were selected: (a) original data reported in Dutch, English, French or German; (b) at least one universal

  20. The Design, Implementation, and Evaluation of Online Credit Nutrition Courses: A Systematic Review

    Science.gov (United States)

    Cohen, Nancy L.; Carbone, Elena T.; Beffa-Negrini, Patricia A.

    2011-01-01

    Objective: To assess how postsecondary online nutrition education courses (ONEC) are delivered, determine ONEC effectiveness, identify theoretical models used, and identify future research needs. Design: Systematic search of database literature. Setting: Postsecondary education. Participants: Nine research articles evaluating postsecondary ONEC.…

  1. Systematic evaluation of the descriptive and predictive performance of Paediatric morphine population models

    NARCIS (Netherlands)

    E.H.J. Krekels (Elke); J.G.C. van Hasselt (Johan); D. Tibboel (Dick); M. Danhof (Meindert); C.A.J. Knibbe (Catherijne)

    2011-01-01

    textabstractPurpose: A framework for the evaluation of paediatric population models is proposed and applied to two different paediatric population pharmacokinetic models for morphine. One covariate model was based on a systematic covariate analysis, the other on fixed allometric scaling principles.

  2. Measuring Health Literacy in Individuals with Diabetes: A Systematic Review and Evaluation of Available Measures

    Science.gov (United States)

    Al Sayah, Fatima; Williams, Beverly; Johnson, Jeffrey A.

    2013-01-01

    Objective: To identify instruments used to measure health literacy and numeracy in people with diabetes; evaluate their use, measurement scope, and properties; discuss their strengths and weaknesses; and propose the most useful, reliable, and applicable measure for use in research and practice settings. Methods" A systematic literature review…

  3. The Estimation and Inclusion of Presenteeism Costs in Applied Economic Evaluation: A Systematic Review.

    OpenAIRE

    Kigozi, J; Jowett, S; Lewis, M; Barton, P.; Coast, J

    2017-01-01

    OBJECTIVE: Given the significant costs of reduced productivity (presenteeism) in comparison to absenteeism, and overall societal costs, presenteeism has a potentially important role to play in economic evaluations. However, these costs are often excluded. The objective of this study is to review applied cost of illness studies and economic evaluations to identify valuation methods used for, and impact of including presenteeism costs in practice. METHODS: A structured systematic review was car...

  4. Evaluation of fetal kidney growth using ultrasound: A systematic review.

    Science.gov (United States)

    Brennan, Sonja; Watson, David; Rudd, Donna; Schneider, Michal; Kandasamy, Yogavijayan

    2017-11-01

    To determine the role of ultrasound imaging in evaluating fetal kidney growth. MEDLINE, CINAHL and EMBASE databases were electronically searched for studies between 1996 and January 2017 and limited to English language. Studies were included if they reported on an ultrasound technique to assess fetal kidney growth and they were not a case report or case series. There was independent selection of studies by two reviewers in consensus with one other reviewer. Data were extracted by one reviewer in consensus with two other reviewers. A total of 1785 articles were identified. The full text of 39 of these were assessed for eligibility for inclusion. Twenty-eight studies were then included in the review. Standard two dimensional (2D) fetal renal measurements are easy to perform, however, this review identified that most studies had some methodological limitations. The disadvantage with 2D and three dimensional (3D) fetal renal volumes are that they include the entire kidney and good reproducibility of 3D volumes has not yet been demonstrated. Currently there is limited research on fetal kidney growth in the setting of abnormal fetal growth. Research focussing directly on fetal kidney parenchyma and blood flow is scarce. Some nomograms of 2D and 3D fetal kidney size and volume have been developed. Kidney length is the most popular single fetal kidney measurement; however, it does not seem to be a good indicator of growth. In IUGR fetuses, kidney length remained similar to appropriately grown fetuses whereas AP and TS dimensions were significantly decreased. New ultrasound techniques focusing on the parenchyma of the kidney and perfusion to the kidney should be explored as they may provide more meaningful information on kidney development in the fetus and future kidney function. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Neural bases of pharmacological treatment of nicotine dependence - insights from functional brain imaging: a systematic review

    NARCIS (Netherlands)

    Menossi, Henrique Soila; Goudriaan, Anna E.; de Azevedo-Marques Périco, Cintia; Nicastri, Sérgio; de Andrade, Arthur Guerra; D'Elia, Gilberto; Li, Chiang-Shan R.; Castaldelli-Maia, João Mauricio

    2013-01-01

    Nicotine dependence is difficult to treat, and the biological mechanisms that are involved are not entirely clear. There is an urgent need to develop better drugs and more effective treatments for clinical practice. A critical step towards accelerating progress in medication development is to

  6. A systematic evaluation of a multidisciplinary social work-lawyer elder mistreatment intervention model.

    Science.gov (United States)

    Rizzo, Victoria M; Burnes, David; Chalfy, Amy

    2015-01-01

    This study introduces a conceptually based, systematic evaluation process employing multivariate techniques to evaluate a multidisciplinary social work-lawyer intervention model (JASA-LEAP). Logistic regression analyses were used with a random sample of case records (n = 250) from three intervention sites. Client retention, program fidelity, and exposure to multidisciplinary services were significantly related to reduction in mistreatment risk at case closure. Female gender, married status, and living with perpetrator significantly predicted unfavorable outcomes. This study extends the elder mistreatment program evaluation literature beyond descriptive/bivariate evaluation strategies. Findings suggest that a multidisciplinary social work-lawyer elder mistreatment intervention model is a successful approach.

  7. Performance of clear vacuum-formed thermoplastic retainers depending on retention protocol: a systematic review.

    Science.gov (United States)

    Kaklamanos, Eleftherios G; Kourakou, Maria; Kloukos, Dimitrios; Doulis, Ioannis; Kavvadia, Smaragda

    2017-04-01

    We aimed at comparing the performance of vacuum-formed thermoplastic retainers (VFR) worn either full-time or part-time, in maintaining orthodontic treatment results in terms of tooth alignment, arch form and occlusion. We reviewed randomized and prospective controlled clinical trials comparing VFR wearing protocols and searched databases, without restrictions, for published and unpublished literature. The risk of bias was assessed using the Cochrane Risk of Bias tool and the overall level of certainty in the evidence following ADA methodology. 184 studies were initially identified and reduced to the 3 randomized controlled trials included in the systematic review by means of specific criteria. One study followed patients 1 year into retention, and the other two for 6 months. Little's Irregularity Index, intermolar and intercanine width, arch length, overjet and PAR score did not differ significantly between the patients wearing their retainers part time or full time. We observed a slight increase in the overbite in the part-time group in only one trial. With a moderate level of certainty, we found that during the observation period, full-time VFR wear is not superior to part-time, bearing in mind the potential implications for health burden, retainer longevity and cost-effectiveness, as well as patient satisfaction and compliance.

  8. Systematic evaluation of implementation fidelity of complex interventions in health and social care

    Directory of Open Access Journals (Sweden)

    Hasson Henna

    2010-09-01

    Full Text Available Abstract Background Evaluation of an implementation process and its fidelity can give insight into the 'black box' of interventions. However, a lack of standardized methods for studying fidelity and implementation process have been reported, which might be one reason for the fact that few prior studies in the field of health service research have systematically evaluated interventions' implementation processes. The aim of this project is to systematically evaluate implementation fidelity and possible factors influencing fidelity of complex interventions in health and social care. Methods A modified version of The Conceptual Framework for Implementation Fidelity will be used as a conceptual model for the evaluation. The modification implies two additional moderating factors: context and recruitment. A systematic evaluation process was developed. Multiple case study method is used to investigate implementation of three complex health service interventions. Each case will be investigated in depth and longitudinally, using both quantitative and qualitative methods. Discussion This study is the first attempt to empirically test The Conceptual Framework for Implementation Fidelity. The study can highlight mechanism and factors of importance when implementing complex interventions. Especially the role of the moderating factors on implementation fidelity can be clarified. Trial Registration Supported Employment, SE, among people with severe mental illness -- a randomized controlled trial: NCT00960024.

  9. Associations of 5HTTLPR polymorphism with major depressive disorder and alcohol dependence: A systematic review and meta-analysis.

    Science.gov (United States)

    Oo, Khine Zin; Aung, Ye Kyaw; Jenkins, Mark A; Win, Aung Ko

    2016-09-01

    The neurotransmitter serotonin is understood to control mood and drug response. Carrying a genetic variant in the serotonin transporter gene (5HTT) may increase the risk of major depressive disorder and alcohol dependence. Previous estimates of the association of the S allele of 5HTTLPR polymorphism with major depressive disorder and alcohol dependence have been inconsistent. For the systematic review, we used PubMed MEDLINE and Discovery of The University of Melbourne to search for all relevant case-control studies investigating the associations of 5HTTLPR polymorphism with major depressive disorder and alcohol dependence. Summary odds ratios (OR) and their 95% confidence intervals (CI) were estimated. To investigate whether year of publication, study population or diagnostic criteria used were potential sources of heterogeneity, we performed meta-regression analyses. Publication bias was assessed using Funnel plots and Egger's statistical tests. We included 23 studies of major depressive disorder without alcohol dependence containing 3392 cases and 5093 controls, and 11 studies of alcohol dependence without major depressive disorder containing 2079 cases and 2273 controls. The summary OR for homozygote carriers of the S allele of 5HTTLPR polymorphism compared with heterozygote and non-carriers combined (SS vs SL+LL genotype) was 1.33 (95% CI = [1.19, 1.48]) for major depressive disorder and 1.18 (95% CI = [1.01, 1.38]) for alcohol dependence. The summary OR per S allele of 5HTTLPR polymorphism was 1.16 (95% CI = [1.08, 1.23]) for major depressive disorder and 1.12 (95% CI = [1.01, 1.23]) for alcohol dependence. Meta-regression models showed that the associations did not substantially change after adjusting for year of publication, study population and diagnostic criteria used. There was no evidence for publication bias of the studies included in our meta-analysis. Our meta-analysis confirms that individuals with the homozygous S allele of 5HTTLPR

  10. Ethnic background and genetic variation in the evaluation of cancer risk: a systematic review.

    Directory of Open Access Journals (Sweden)

    Lijun Jing

    Full Text Available The clinical use of genetic variation in the evaluation of cancer risk is expanding, and thus understanding how determinants of cancer susceptibility identified in one population can be applied to another is of growing importance. However there is considerable debate on the relevance of ethnic background in clinical genetics, reflecting both the significance and complexity of genetic heritage. We address this via a systematic review of reported associations with cancer risk for 82 markers in 68 studies across six different cancer types, comparing association results between ethnic groups and examining linkage disequilibrium between risk alleles and nearby genetic loci. We find that the relevance of ethnic background depends on the question. If asked whether the association of variants with disease risk is conserved across ethnic boundaries, we find that the answer is yes, the majority of markers show insignificant variability in association with cancer risk across ethnic groups. However if the question is whether a significant association between a variant and cancer risk is likely to reproduce, the answer is no, most markers do not validate in an ethnic group other than the discovery cohort's ancestry. This lack of reproducibility is not attributable to studies being inadequately populated due to low allele frequency in other ethnic groups. Instead, differences in local genomic structure between ethnic groups are associated with the strength of association with cancer risk and therefore confound interpretation of the implied physiologic association tracked by the disease allele. This suggest that a biological association for cancer risk alleles may be broadly consistent across ethnic boundaries, but reproduction of a clinical study in another ethnic group is uncommon, in part due to confounding genomic architecture. As clinical studies are increasingly performed globally this has important implications for how cancer risk stratifiers should be

  11. Systematic error of lidar profiles caused by a polarization-dependent receiver transmission: quantification and error correction scheme.

    Science.gov (United States)

    Mattis, Ina; Tesche, Matthias; Grein, Matthias; Freudenthaler, Volker; Müller, Detlef

    2009-05-10

    Signals of many types of aerosol lidars can be affected with a significant systematic error, if depolarizing scatterers are present in the atmosphere. That error is caused by a polarization-dependent receiver transmission. In this contribution we present an estimation of the magnitude of this systematic error. We show that lidar signals can be biased by more than 20%, if linearly polarized laser light is emitted, if both polarization components of the backscattered light are measured with a single detection channel, and if the receiver transmissions for these two polarization components differ by more than 50%. This signal bias increases with increasing ratio between the two transmission values (transmission ratio) or with the volume depolarization ratio of the scatterers. The resulting error of the particle backscatter coefficient increases with decreasing backscatter ratio. If the particle backscatter coefficients are to have an accuracy better than 5%, the transmission ratio has to be in the range between 0.85 and 1.15. We present a method to correct the measured signals for this bias. We demonstrate an experimental method for the determination of the transmission ratio. We use collocated measurements of a lidar system strongly affected by this signal bias and an unbiased reference system to verify the applicability of the correction scheme. The errors in the case of no correction are illustrated with example measurements of fresh Saharan dust.

  12. A systematic review of evaluation research in integrated behavioral health care: Operational and financial characteristics.

    Science.gov (United States)

    Muse, Amelia R; Lamson, Angela L; Didericksen, Katharine W; Hodgson, Jennifer L

    2017-06-01

    Integrated behavioral health care (IBHC) is an emerging solution for the delivery of behavioral health in primary care contexts. Although IBHC has been implemented and studied for more than 2 decades, little seems to be known about how it is best evaluated. This article illustrates a framework for IBHC evaluation based on the Three World view (with a focus on the operational and financial worlds) and delivers results from a systematic review on the operational and financial characteristics of existing IBHC research. This study identified original reports of research that included an evaluation or assessment of the operational or financial success or sustainability of IBHC sites or programs. A total of 3,386 articles were found through the selected databases and 46 articles were found to meet the inclusion criteria. From the 46 articles that contained an IBHC evaluation including operational or financial variables, 9 operational and 11 financial characteristics were identified as barriers or strengths to sustainability or success. The characteristics of the evaluation participants, IBHC settings, and method of evaluation were also coded and analyzed. As a result of this systematic review of articles, evaluation of the success and sustainability of the operational and financial worlds can now be conceptualized at provider and practice levels. Collaboration and communication between medical and behavioral health providers was a significant operational characteristic related to success and sustainability. Financial characteristics indicated that continuous financial evaluation throughout implementation was important to success and sustainability. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  13. Global dependence of field-observed leaf area index in woody species on climate: a systematic review

    NARCIS (Netherlands)

    Iio, A.; Hikosaka, K.; Anten, N.P.R.; Nakagawa, Y.; Ito, A.

    2014-01-01

    Aim Leaf area index (LAI) is one of the key variables related to carbon, water and nutrient cycles in terrestrial ecosystems, but its global distribution patterns remain poorly understood.We evaluated the dependence of LAI on mean annual temperature (MAT) and wetness index (WI; a ratio of annual

  14. Evidence-based evaluation of information: the centrality and limitations of systematic reviews.

    Science.gov (United States)

    Järvholm, Bengt; Bohlin, Ingemar

    2014-03-01

    This introductory paper considers the value and limitations of the methodology of systematic reviews especially according to the evidence-based movement. It explains some terms and organisations producing systematic reviews. It also discusses controversies. The first concerns the criteria by which the quality of individual studies is assessed, the second the possible effects of the affiliation of some reviewers, and the third the value of formalisation of procedure (i.e. the tensions between formal tools and professional judgments). The article contrasts the evidence-based formalism with other formalisms as those by the Intergovernmental Panel on Climate Change and the International Agency for Research on Cancer. It discusses systematic reviews in social science where interventions are complex, difficult to blind, and depend on context. Systematic reviews in working life research are often focusing on prevention. The formal evidence-based process may devaluate or disregard findings from mechanistic and observational studies. Hence such reviews may falsely conclude that existing knowledge about the risk of the factor is limited or nonexistent.

  15. A systematic review and economic evaluation of bisphosphonates for the prevention of fragility fractures.

    Science.gov (United States)

    Davis, Sarah; Martyn-St James, Marrissa; Sanderson, Jean; Stevens, John; Goka, Edward; Rawdin, Andrew; Sadler, Susi; Wong, Ruth; Campbell, Fiona; Stevenson, Matt; Strong, Mark; Selby, Peter; Gittoes, Neil

    2016-10-01

    Fragility fractures are fractures that result from mechanical forces that would not ordinarily result in fracture. To evaluate the clinical effectiveness and safety of bisphosphonates [alendronic acid (Fosamax ® and Fosamax ® Once Weekly, Merck Sharp & Dohme Ltd), risedronic acid (Actonel ® and Actonel Once a Week ® , Warner Chilcott UK Ltd), ibandronic acid (Bonviva ® , Roche Products Ltd) and zoledronic acid (Aclasta ® , Novartis Pharmaceuticals UK Ltd)] for the prevention of fragility fracture and to assess their cost-effectiveness at varying levels of fracture risk. For the clinical effectiveness review, six electronic databases and two trial registries were searched: MEDLINE, EMBASE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Web of Science and BIOSIS Previews, Clinicaltrials.gov and World Health Organization International Clinical Trials Registry Platform. Searches were limited by date from 2008 until September 2014. A systematic review and network meta-analysis (NMA) of effectiveness studies were conducted. A review of published economic analyses was undertaken and a de novo health economic model was constructed. Discrete event simulation was used to estimate lifetime costs and quality-adjusted life-years (QALYs) for each bisphosphonate treatment strategy and a strategy of no treatment for a simulated cohort of patients with heterogeneous characteristics. The model was populated with effectiveness evidence from the systematic review and NMA. All other parameters were estimated from published sources. A NHS and Personal Social Services perspective was taken, and costs and benefits were discounted at 3.5% per annum. Fracture risk was estimated from patient characteristics using the QFracture ® (QFracture-2012 open source revision 38, Clinrisk Ltd, Leeds, UK) and FRAX ® (web version 3.9, University of Sheffield, Sheffield, UK) tools. The relationship between fracture risk and incremental net benefit (INB) was

  16. Evaluation of binding strength depending on the adhesive binding methods

    Directory of Open Access Journals (Sweden)

    Suzana Pasanec Preprotić

    2015-05-01

    Full Text Available A book with a personal value is worth remembering since it represents specific interests of an individual - author of the book. Therefore the original is the first issue of a book which is always bound manually. Due to cost-effectiveness, adhesive binding is most commonly used in author’s edition in paperback and hardback. Adhesive binding methods differ only if a paper leaf is a binding unit in adhesive binding form. The subject of the research is the quality of book block binding for two binding methods with/without mull fabric. The assumption is that double-fan adhesive binding method shows an extraordinary binding quality as compared to the rough spine method. For the needs of this research book block parameters remained unaltered: paper type, size and book volume. The results related to strength were obtained by using an experimental method of tensile strength for individual paper leaves. The rating of book block quality was conducted in accordance with FOGRA Nr.71006 guidelines for page pull-test. Furthermore, strength results for both methods were compared in order to evaluate the importance of changing the quality of adhesive binding. Statistical method ANOVA analysis of variance and Fisher’s F-test were used to evaluate the quality of book block binding.

  17. Process variables in organizational stress management intervention evaluation research: a systematic review.

    Science.gov (United States)

    Havermans, Bo M; Schlevis, Roosmarijn Mc; Boot, Cécile Rl; Brouwers, Evelien Pm; Anema, Johannes; van der Beek, Allard J

    2016-09-01

    This systematic review aimed to explore which process variables are used in stress management intervention (SMI) evaluation research. A systematic review was conducted using seven electronic databases. Studies were included if they reported on an SMI aimed at primary or secondary stress prevention, were directed at paid employees, and reported process data. Two independent researchers checked all records and selected the articles for inclusion. Nielsen and Randall's model for process evaluation was used to cluster the process variables. The three main clusters were context, intervention, and mental models. In the 44 articles included, 47 process variables were found, clustered into three main categories: context (two variables), intervention (31 variables), and mental models (14 variables). Half of the articles contained no reference to process evaluation literature. The collection of process evaluation data mostly took place after the intervention and at the level of the employee. The findings suggest that there is great heterogeneity in methods and process variables used in process evaluations of SMI. This, together with the lack of use of a standardized framework for evaluation, hinders the advancement of process evaluation theory development.

  18. A systematic evaluation of token economies as a classroom management tool for students with challenging behavior.

    Science.gov (United States)

    Maggin, Daniel M; Chafouleas, Sandra M; Goddard, Katelyn M; Johnson, Austin H

    2011-10-01

    A two-part systematic review was undertaken to assess the effectiveness of token economies in increasing rates of appropriate classroom behavior for students demonstrating behavioral difficulties. The first part of the review utilized the recently published What Works Clearinghouse (WWC) standards for evaluating single-subject research to determine the extent to which eligible studies demonstrated sufficient evidence to classify the token economy as an evidence-based practice. The second part of the review employed meta-analytic techniques across four different types of effect sizes to evaluate the quantitative strength of the findings. Methodological strengths and weaknesses across the studies were systematically investigated. Results indicated that the extant research on token economies does not provide sufficient evidence to be deemed best-practice based on the WWC criteria. Published by Elsevier Ltd.

  19. Time dependent evaluation of the lightning upward connecting leader inception

    Energy Technology Data Exchange (ETDEWEB)

    Becerra, Marley; Cooray, Vernon [Division for Electricity and Lightning Research, Uppsala University (Sweden) and Angstroem Laboratory, Box 534, SE 751 21, Uppsala (Sweden)

    2006-11-07

    The evaluation of the upward connecting leader inception from a grounded structure has generally been performed neglecting the effect of the propagation of the downward stepped leader. Nevertheless, field observations suggest that the space charge produced by streamer corona and aborted upward leaders during the approach of the downward lightning leader can influence significantly the initiation of stable upward positive leaders. Thus, a physical leader inception model is developed, which takes into account the electric field variations produced by the descending leader during the process of inception. Also, it accounts for the shielding effect produced by streamer corona and unstable leaders formed before the stable leader inception takes place. The model is validated by comparing its predictions with the results obtained in long gap experiments and in an altitude triggered lightning experiment. The model is then used to estimate the leader inception conditions for free standing rods as a function of tip radius and height. It is found that the rod radius slightly affects the height of the downward leader tip necessary to initiate upward leaders. Only an improvement of about 10% on the lightning attractiveness can be reached by using lightning rods with an optimum radius. Based on the obtained results, the field observations of competing lightning rods are explained. Furthermore, the influence of the average stepped leader velocity on the inception of positive upward leaders is evaluated. The results obtained show that the rate of change of the background electric field produced by a downward leader descent largely influences the conditions necessary for upward leader initiation. Estimations of the leader inception conditions for the upper and lower limit of the measured values of the average downward lightning leader velocity differ by more than 80%. In addition, the striking distances calculated taking into account the temporal change of the background field are

  20. Time dependent evaluation of the lightning upward connecting leader inception

    Science.gov (United States)

    Becerra, Marley; Cooray, Vernon

    2006-11-01

    The evaluation of the upward connecting leader inception from a grounded structure has generally been performed neglecting the effect of the propagation of the downward stepped leader. Nevertheless, field observations suggest that the space charge produced by streamer corona and aborted upward leaders during the approach of the downward lightning leader can influence significantly the initiation of stable upward positive leaders. Thus, a physical leader inception model is developed, which takes into account the electric field variations produced by the descending leader during the process of inception. Also, it accounts for the shielding effect produced by streamer corona and unstable leaders formed before the stable leader inception takes place. The model is validated by comparing its predictions with the results obtained in long gap experiments and in an altitude triggered lightning experiment. The model is then used to estimate the leader inception conditions for free standing rods as a function of tip radius and height. It is found that the rod radius slightly affects the height of the downward leader tip necessary to initiate upward leaders. Only an improvement of about 10% on the lightning attractiveness can be reached by using lightning rods with an optimum radius. Based on the obtained results, the field observations of competing lightning rods are explained. Furthermore, the influence of the average stepped leader velocity on the inception of positive upward leaders is evaluated. The results obtained show that the rate of change of the background electric field produced by a downward leader descent largely influences the conditions necessary for upward leader initiation. Estimations of the leader inception conditions for the upper and lower limit of the measured values of the average downward lightning leader velocity differ by more than 80%. In addition, the striking distances calculated taking into account the temporal change of the background field are

  1. CT evaluation of soft tissue and muscle infection and inflammation: A systematic compartmental approach

    Energy Technology Data Exchange (ETDEWEB)

    Beauchamp, N.J. Jr. [Dept. of Radiology, and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, MD (United States); Scott, W.W. Jr. [Dept. of Radiology, and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, MD (United States); Gottlieb, L.M. [Dept. of Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD (United States); Fishman, E.K. [Dept. of Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD (United States)

    1995-07-01

    This essay presents a systematic approach to the evaluation of soft tissue and muscle infection by defining the various pathologic processes and then illustrating them through a series of CT studies with corresponding schematic diagrams. The specific processes discussed are cellulitis, lymphangitis/lymphedema, necrotizing fascitis, myositis/myonecrosis, and abscess. Key points in the differential diagnosis of these entities are discussed and illustrated. The clinical management of the specific pathologic processes is also discussed. (orig./MG)

  2. A systematic review of factors influencing student ratings in undergraduate medical education course evaluations

    OpenAIRE

    Schiekirka, Sarah; Raupach, Tobias

    2015-01-01

    Background Student ratings are a popular source of course evaluations in undergraduate medical education. Data on the reliability and validity of such ratings have mostly been derived from studies unrelated to medical education. Since medical education differs considerably from other higher education settings, an analysis of factors influencing overall student ratings with a specific focus on medical education was needed. Methods For the purpose of this systematic review, online databases (Pu...

  3. Evaluation of Implant Collar Surfaces for Marginal Bone Loss: A Systematic Review and Meta-Analysis

    OpenAIRE

    Roodabeh Koodaryan; Ali Hafezeqoran

    2016-01-01

    Background. It is important to understand the influence of different collar designs on peri-implant marginal bone loss, especially in the critical area. Objectives. The purpose of the present systematic review and meta-analysis was to compare dental implants with different collar surfaces, evaluating marginal bone loss and survival rates of implants. Methods. Eligibility criteria included clinical human studies, randomized controlled trials, and prospective and retrospective studies, which ev...

  4. Quality Assessment of Studies Published in Open Access and Subscription Journals: Results of a Systematic Evaluation.

    Science.gov (United States)

    Pastorino, Roberta; Milovanovic, Sonja; Stojanovic, Jovana; Efremov, Ljupcho; Amore, Rosarita; Boccia, Stefania

    2016-01-01

    Along with the proliferation of Open Access (OA) publishing, the interest for comparing the scientific quality of studies published in OA journals versus subscription journals has also increased. With our study we aimed to compare the methodological quality and the quality of reporting of primary epidemiological studies and systematic reviews and meta-analyses published in OA and non-OA journals. In order to identify the studies to appraise, we listed all OA and non-OA journals which published in 2013 at least one primary epidemiologic study (case-control or cohort study design), and at least one systematic review or meta-analysis in the field of oncology. For the appraisal, we picked up the first studies published in 2013 with case-control or cohort study design from OA journals (Group A; n = 12), and in the same time period from non-OA journals (Group B; n = 26); the first systematic reviews and meta-analyses published in 2013 from OA journals (Group C; n = 15), and in the same time period from non-OA journals (Group D; n = 32). We evaluated the methodological quality of studies by assessing the compliance of case-control and cohort studies to Newcastle and Ottawa Scale (NOS) scale, and the compliance of systematic reviews and meta-analyses to Assessment of Multiple Systematic Reviews (AMSTAR) scale. The quality of reporting was assessed considering the adherence of case-control and cohort studies to STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist, and the adherence of systematic reviews and meta-analyses to Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) checklist. Among case-control and cohort studies published in OA and non-OA journals, we did not observe significant differences in the median value of NOS score (Group A: 7 (IQR 7-8) versus Group B: 8 (7-9); p = 0.5) and in the adherence to STROBE checklist (Group A, 75% versus Group B, 80%; p = 0.1). The results did not change after adjustment

  5. Quality Assessment of Studies Published in Open Access and Subscription Journals: Results of a Systematic Evaluation.

    Directory of Open Access Journals (Sweden)

    Roberta Pastorino

    Full Text Available Along with the proliferation of Open Access (OA publishing, the interest for comparing the scientific quality of studies published in OA journals versus subscription journals has also increased. With our study we aimed to compare the methodological quality and the quality of reporting of primary epidemiological studies and systematic reviews and meta-analyses published in OA and non-OA journals.In order to identify the studies to appraise, we listed all OA and non-OA journals which published in 2013 at least one primary epidemiologic study (case-control or cohort study design, and at least one systematic review or meta-analysis in the field of oncology. For the appraisal, we picked up the first studies published in 2013 with case-control or cohort study design from OA journals (Group A; n = 12, and in the same time period from non-OA journals (Group B; n = 26; the first systematic reviews and meta-analyses published in 2013 from OA journals (Group C; n = 15, and in the same time period from non-OA journals (Group D; n = 32. We evaluated the methodological quality of studies by assessing the compliance of case-control and cohort studies to Newcastle and Ottawa Scale (NOS scale, and the compliance of systematic reviews and meta-analyses to Assessment of Multiple Systematic Reviews (AMSTAR scale. The quality of reporting was assessed considering the adherence of case-control and cohort studies to STrengthening the Reporting of OBservational studies in Epidemiology (STROBE checklist, and the adherence of systematic reviews and meta-analyses to Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA checklist.Among case-control and cohort studies published in OA and non-OA journals, we did not observe significant differences in the median value of NOS score (Group A: 7 (IQR 7-8 versus Group B: 8 (7-9; p = 0.5 and in the adherence to STROBE checklist (Group A, 75% versus Group B, 80%; p = 0.1. The results did not change after

  6. The Evaluation of Hospital Performance in Iran: A Systematic Review Article.

    Science.gov (United States)

    Bahadori, Mohammadkarim; Izadi, Ahmad Reza; Ghardashi, Fatemeh; Ravangard, Ramin; Hosseini, Seyed Mojtaba

    2016-07-01

    This research aimed to systematically study and outline the methods of hospital performance evaluation used in Iran. In this systematic review, all Persian and English-language articles published in the Iranian and non-Iranian scientific journals indexed from Sep 2004 to Sep 2014 were studied. For finding the related articles, the researchers searched the Iranian electronic databases, including SID, IranMedex, IranDoc, Magiran, as well as the non-Iranian electronic databases, including Medline, Embase, Scopus, and Google Scholar. For reviewing the selected articles, a data extraction form, developed by the researchers was used. The entire review process led to the selection of 51 articles. The publication of articles on the hospital performance evaluation in Iran has increased considerably in the recent years. Besides, among these 51 articles, 38 articles (74.51%) had been published in Persian language and 13 articles (25.49%) in English language. Eight models were recognized as evaluation model for Iranian hospitals. Totally, in 15 studies, the data envelopment analysis model had been used to evaluate the hospital performance. Using a combination of model to integrate indicators in the hospital evaluation process is inevitable. Therefore, the Ministry of Health and Medical Education should use a set of indicators such as the balanced scorecard in the process of hospital evaluation and accreditation and encourage the hospital managers to use them.

  7. Systematic Observation of Time-Dependent Phenomena in the RF Output Spectrum of High Power Gyrotrons

    Directory of Open Access Journals (Sweden)

    Kern Stefan

    2012-09-01

    Full Text Available At IHM/KIT, high power gyrotrons with conventional cavity (e.g. 1 MW CW at 140 GHz for the stellarator Wendelstein 7-X and coaxial cavity (2 MW shortpulse at 170 GHz for ITER for fusion applications are being developed and verified experimentally. Especially with respect to the problem of parasitic RF oscillations in the beam tunnel of some W7-X tubes, investigations of the gyrotron RF output spectrum have proved to be a valuable source of diagnostic information. Signs of transient effects in millisecond pulses, like frequency switching or intermittent low-frequency modulation, have indicated that truly time-dependent measurements with high frequency resolution and dynamic range could give deeper insight into these phenomena. In this paper, an improved measurement system is presented, which employs a fast oscilloscope as receiver. Shorttime Fourier transform (STFT is applied to the time-domain signal, yielding time-variant spectra with frequency resolutions only limited by acquisition length and STFT segmentation choice. Typical reasonable resolutions are in the range of 100 kHz to 10 MHz with a currently memory-limited maximum acquisition length of 4 ms. A key feature of the system consists in the unambiguity of frequency measurement: The system receives through two parallel channels, each using a harmonic mixer (h = 9 – 12 to convert the signal from RF millimeter wave frequencies (full D-Band, 110 – 170 GHz to IF (0 – 3 GHz. For each IF output signal of each individual mixer, injection side and receiving harmonic are initially not known. Using accordingly determined LO frequencies, this information is retrieved from the redundancy of the channels, yielding unambiguously reconstructed RF spectra with a total span of twice the usable receiver IF bandwidth, up to ≈ 6 GHz in our case. Using the system, which is still being improved continuously, various transient effects like cavity mode switching, parasitic oscillation frequency variation

  8. Systematic analysis of nucleation-dependent polymerization reveals new insights into the mechanism of amyloid self-assembly.

    Science.gov (United States)

    Xue, Wei-Feng; Homans, Steve W; Radford, Sheena E

    2008-07-01

    Self-assembly of misfolded proteins into ordered fibrillar aggregates known as amyloid results in numerous human diseases. Despite an increasing number of proteins and peptide fragments being recognised as amyloidogenic, how these amyloid aggregates assemble remains unclear. In particular, the identity of the nucleating species, an ephemeral entity that defines the rate of fibril formation, remains a key outstanding question. Here, we propose a new strategy for analyzing the self-assembly of amyloid fibrils involving global analysis of a large number of reaction progress curves and the subsequent systematic testing and ranking of a large number of possible assembly mechanisms. Using this approach, we have characterized the mechanism of the nucleation-dependent formation of beta(2)-microglobulin (beta(2)m) amyloid fibrils. We show, by defining nucleation in the context of both structural and thermodynamic aspects, that a model involving a structural nucleus size approximately the size of a hexamer is consistent with the relatively small concentration dependence of the rate of fibril formation, contrary to expectations based on simpler theories of nucleated assembly. We also demonstrate that fibril fragmentation is the dominant secondary process that produces higher apparent cooperatively in fibril formation than predicted by nucleated assembly theories alone. The model developed is able to explain and predict the behavior of beta(2)m fibril formation and provides a rationale for explaining generic properties observed in other amyloid systems, such as fibril growth acceleration and pathway shifts under agitation.

  9. Economic Evaluation and Transferability of Physical Activity Programmes in Primary Prevention: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Silke B. Wolfenstetter

    2010-04-01

    Full Text Available This systematic review aims to assess the characteristics of, and the clinical and economic evidence provided by, economic evaluations of primary preventive physical exercise interventions, and to analyse their transferability to Germany using recommended checklists. Fifteen economic evaluations from seven different countries met eligibility criteria, with seven of the fifteen providing high economic evidence in the special country context. Most of the identified studies conclude that the investigated intervention provide good value for money compared with alternatives. However, this review shows a high variability of the costing methods between the studies, which limits comparability, generalisability and transferability of the results.

  10. Economic Evaluation and Transferability of Physical Activity Programmes in Primary Prevention: A Systematic Review

    Science.gov (United States)

    Wolfenstetter, Silke B.; Wenig, Christina M.

    2010-01-01

    This systematic review aims to assess the characteristics of, and the clinical and economic evidence provided by, economic evaluations of primary preventive physical exercise interventions, and to analyse their transferability to Germany using recommended checklists. Fifteen economic evaluations from seven different countries met eligibility criteria, with seven of the fifteen providing high economic evidence in the special country context. Most of the identified studies conclude that the investigated intervention provide good value for money compared with alternatives. However, this review shows a high variability of the costing methods between the studies, which limits comparability, generalisability and transferability of the results. PMID:20617050

  11. Systematic studies of charge-dependent azimuthal correlation in pPb and PbPb collisions at the LHC

    CERN Document Server

    Tu, Zhoudunming

    2017-01-01

    Studies of charge-dependent azimuthal correlations for same- and opposite-sign particle pairs are presented in PbPb collisions at 5.02 TeV and pPb collisions at 5.02 and 8.16 TeV, with the CMS experiment at the LHC. The azimuthal correlations are evaluated with respect to the second- and also higher-order event planes, as a function of particle pseudorapidity and transverse momentum, and event multiplicity. By employing an event-shape engineering technique, the dependence of correlations on azimuthal anisotropy flow is investigated. Results presented provide new insights to the origin of observed charge-dependent azimuthal correlations, and have important implications to the search for the chiral magnetic effect in heavy ion collisions.

  12. The effect of a geriatric evaluation on treatment decisions for older cancer patients--a systematic review

    NARCIS (Netherlands)

    Hamaker, Marije E.; Schiphorst, Anandi H.; ten Bokkel Huinink, Daan; Schaar, Cees; van Munster, Barbara C.

    2014-01-01

    The aim of this systematic review is to summarise all available data on the effect of a geriatric evaluation on the multidisciplinary treatment of older cancer patients, focussing on oncologic treatment decisions and the implementation of non-oncologic interventions. A systematic search in MEDLINE

  13. Consensus Recommendations for Systematic Evaluation of Drug-Drug Interaction Evidence for Clinical Decision Support

    Science.gov (United States)

    Scheife, Richard T.; Hines, Lisa E.; Boyce, Richard D.; Chung, Sophie P.; Momper, Jeremiah; Sommer, Christine D.; Abernethy, Darrell R.; Horn, John; Sklar, Stephen J.; Wong, Samantha K.; Jones, Gretchen; Brown, Mary; Grizzle, Amy J.; Comes, Susan; Wilkins, Tricia Lee; Borst, Clarissa; Wittie, Michael A.; Rich, Alissa; Malone, Daniel C.

    2015-01-01

    Background Healthcare organizations, compendia, and drug knowledgebase vendors use varying methods to evaluate and synthesize evidence on drug-drug interactions (DDIs). This situation has a negative effect on electronic prescribing and medication information systems that warn clinicians of potentially harmful medication combinations. Objective To provide recommendations for systematic evaluation of evidence from the scientific literature, drug product labeling, and regulatory documents with respect to DDIs for clinical decision support. Methods A conference series was conducted to develop a structured process to improve the quality of DDI alerting systems. Three expert workgroups were assembled to address the goals of the conference. The Evidence Workgroup consisted of 15 individuals with expertise in pharmacology, drug information, biomedical informatics, and clinical decision support. Workgroup members met via webinar from January 2013 to February 2014. Two in-person meetings were conducted in May and September 2013 to reach consensus on recommendations. Results We developed expert-consensus answers to three key questions: 1) What is the best approach to evaluate DDI evidence?; 2) What evidence is required for a DDI to be applicable to an entire class of drugs?; and 3) How should a structured evaluation process be vetted and validated? Conclusion Evidence-based decision support for DDIs requires consistent application of transparent and systematic methods to evaluate the evidence. Drug information systems that implement these recommendations should be able to provide higher quality information about DDIs in drug compendia and clinical decision support tools. PMID:25556085

  14. [Economic evaluation of antiviral treatment for chronic hepatitis B: a systematic review].

    Science.gov (United States)

    Solari, Lely; Hijar, Gisely; Zavala, Renzo; Ureta, Juan Manuel

    2010-03-01

    To revise the available evidence on the cost-effectiveness of antiviral regimens for treatment of chronic hepatitis B. We performed a systematic revision on MEDLINE, LILACS NICE and COCHRANE databases, searching for economic evaluations of antiviral regimens for treatment of chronic hepatitis B. We included original studies, systematic revisions and management guidelines including information on the cost-effectiveness of this treatment. We registered the characteristics and results of the retrieved documents. We obtained 29 original papers, 4 revision articles and 4 management guidelines. Most of these publications have been done in the last 5 years. There was conflict of interest in 73% of original articles, due to authors working for the pharmaceutical industry. 93% of articles that evaluate the cost-effectiveness of giving treatment for chronic hepatitis B against management of its complications find that it is indeed cost-effective to give antiviral treatment. 3/6 studies that evaluate lamivudine against other drugs find it as a dominant strategy, 3/5 find entecavir as the dominant strategy, 1/1 find tenofovir dominant, ¼ find conventional interferon as dominant and none of them find adefovir or pegylated interferon as dominant strategies. We consider that the available evidence suggests that to give antiviral treatment for chronic hepatitis B is a cost-effective intervention for many health systems, including ours. It has varying indexes of cost-effectiveness according to the evaluated regimens. Ideally , we should perform local economic evaluations in this issue.

  15. How healthcare systems evaluate their advance care planning initiatives: Results from a systematic review.

    Science.gov (United States)

    Biondo, Patricia D; Lee, Lydia D; Davison, Sara N; Simon, Jessica E

    2016-09-01

    Advance care planning initiatives are being implemented across healthcare systems around the world, but how best to evaluate their implementation is unknown. To identify gaps and/or redundancies in current evaluative strategies to help healthcare systems develop future evaluative frameworks for ACP. Systematic review. Peer-reviewed and gray literature searches were conducted till February 2015 to answer: "What methods have healthcare systems used to evaluate implementation of advance care planning initiatives?" A PICOS framework was developed to identify articles describing the implementation and evaluation of a health system-level advance care planning initiative. Outcome measures were mapped onto a conceptual quality indicator framework based on the Institute of Medicine and Donabedian models of healthcare quality. A total of 46 studies met inclusion criteria for analysis. Most articles reported on single parts of a healthcare system (e.g. continuing care). The most common outcome measures pertained to document completion, followed by healthcare resource use. Patient-, family-, or healthcare provider-reported outcomes were less commonly measured. Concordance measures (e.g. dying in place of choice) were reported by only 26% of studies. The conceptual quality indicator framework identified gaps and redundancies in measurement and is presented as a potential foundation from which to develop a comprehensive advance care planning evaluation framework. Document completion is frequently used to evaluate advance care planning program implementation; capturing the quality of care appears to be more difficult. This systematic review provides health system administrators with a comprehensive summary of measures used to evaluate advance care planning and may identify gaps in evaluation within their local context. © The Author(s) 2016.

  16. Modifications and evaluation of smell and taste functions in total laryngectomy: systematic review.

    Science.gov (United States)

    Caldas, Ada Salvetti Cavalcanti; Facundes, Vera Lúcia Dutra; Melo, Thais Myriam Aragão; Dourado Filho, Mário Genuíno; Pinheiro Júnior, Paulo Fernando; Silva, Hilton Justino da

    2011-03-01

    The aim of this study was to systematically review the alterations in smell and taste functions in individuals who underwent total laryngectomy, as well as to identify in the literature some aspects involved in the evaluation of these functions in this population. We performed a systematic review on the databases Medline, LILACS and SciELO, and this data search occurred in October/2010. The search used keywords and free terms, and retrieved 84 articles, 79 from Medline, via Pubmed, and five form LILACS and SciELO. Sixteen of these articles were selected. Most studies in this review attested decline in sensory of smell and taste functions in individuals who underwent total laryngectomy and, although there is consensus regarding the damage caused to these functions by the nasal airflow interruption, it is not yet possible to evidence details in the mechanisms and structures involved, especially regarding the modifications in the olfactory mucous.

  17. Consumer evaluation of food with nutritional benefits: a systematic review and narrative synthesis.

    Science.gov (United States)

    Mogendi, Joseph Birundu; De Steur, Hans; Gellynck, Xavier; Makokha, Anselimo

    2016-06-01

    As a consequence of the growing interest in, and development of, various types of food with nutritional benefits, the modern consumer views their kitchen cabinet more and more as a medicine cabinet. Given that consumer evaluation of food is considered key to the successful production, marketing and finally consumption of food, a procedure commonly used in medical fields was employed to systematically review and summarize evidence of consumer evaluation studies on nutritious foods. The focus is primarily on consumer understanding of nutritious food and the underlying determinants of consumer evaluation. Our results highlight four groups of key determinants: (1) nutrition knowledge and information; (2) attitudes, beliefs, perceptions and behavioural determinants; (3) price, process and product characteristics; and (4) socio-demographics. The findings also point to the importance of understanding consumer acceptance as one many concepts in the consumer evaluation process, and provide support for developing appropriate strategies for improving health and well-being of consumers.

  18. Systematic evaluation of satellite remote sensing for identifying uranium mines and mills.

    Energy Technology Data Exchange (ETDEWEB)

    Blair, Dianna Sue; Stork, Christopher Lyle; Smartt, Heidi Anne; Smith, Jody Lynn

    2006-01-01

    In this report, we systematically evaluate the ability of current-generation, satellite-based spectroscopic sensors to distinguish uranium mines and mills from other mineral mining and milling operations. We perform this systematic evaluation by (1) outlining the remote, spectroscopic signal generation process, (2) documenting the capabilities of current commercial satellite systems, (3) systematically comparing the uranium mining and milling process to other mineral mining and milling operations, and (4) identifying the most promising observables associated with uranium mining and milling that can be identified using satellite remote sensing. The Ranger uranium mine and mill in Australia serves as a case study where we apply and test the techniques developed in this systematic analysis. Based on literature research of mineral mining and milling practices, we develop a decision tree which utilizes the information contained in one or more observables to determine whether uranium is possibly being mined and/or milled at a given site. Promising observables associated with uranium mining and milling at the Ranger site included in the decision tree are uranium ore, sulfur, the uranium pregnant leach liquor, ammonia, and uranyl compounds and sulfate ion disposed of in the tailings pond. Based on the size, concentration, and spectral characteristics of these promising observables, we then determine whether these observables can be identified using current commercial satellite systems, namely Hyperion, ASTER, and Quickbird. We conclude that the only promising observables at Ranger that can be uniquely identified using a current commercial satellite system (notably Hyperion) are magnesium chlorite in the open pit mine and the sulfur stockpile. Based on the identified magnesium chlorite and sulfur observables, the decision tree narrows the possible mineral candidates at Ranger to uranium, copper, zinc, manganese, vanadium, the rare earths, and phosphorus, all of which are

  19. Evaluation Studies of Robotic Rollators by the User Perspective: A Systematic Review.

    Science.gov (United States)

    Werner, Christian; Ullrich, Phoebe; Geravand, Milad; Peer, Angelika; Hauer, Klaus

    2016-01-01

    Robotic rollators enhance the basic functions of established devices by technically advanced physical, cognitive, or sensory support to increase autonomy in persons with severe impairment. In the evaluation of such ambient assisted living solutions, both the technical and user perspectives are important to prove usability, effectiveness and safety, and to ensure adequate device application. The aim of this systematic review is to summarize the methodology of studies evaluating robotic rollators with focus on the user perspective and to give recommendations for future evaluation studies. A systematic literature search up to December 31, 2014, was conducted based on the Cochrane Review methodology using the electronic databases PubMed and IEEE Xplore. Articles were selected according to the following inclusion criteria: evaluation studies of robotic rollators documenting human-robot interaction, no case reports, published in English language. Twenty-eight studies were identified that met the predefined inclusion criteria. Large heterogeneity in the definitions of the target user group, study populations, study designs and assessment methods was found across the included studies. No generic methodology to evaluate robotic rollators could be identified. We found major methodological shortcomings related to insufficient sample descriptions and sample sizes, and lack of appropriate, standardized and validated assessment methods. Long-term use in habitual environment was also not evaluated. Apart from the heterogeneity, methodological deficits in most of the identified studies became apparent. Recommendations for future evaluation studies include: clear definition of target user group, adequate selection of subjects, inclusion of other assistive mobility devices for comparison, evaluation of the habitual use of advanced prototypes, adequate assessment strategy with established, standardized and validated methods, and statistical analysis of study results. Assessment

  20. Photogrammetry as a tool for the postural evaluation of the spine: A systematic review.

    Science.gov (United States)

    Furlanetto, Tássia Silveira; Sedrez, Juliana Adami; Candotti, Cláudia Tarragô; Loss, Jefferson Fagundes

    2016-02-18

    To evaluate the use of photogrammetry and identify the mathematical procedures applied when evaluating spinal posture. A systematic search using keywords was conducted in the PubMed, EMBASE, Scopus, Science and Medicine(®) databases. The following inclusion criteria adopted were: (1) the use of photogrammetry as a method to evaluate spinal posture; (2) evaluations of spinal curvature in the sagittal and/or frontal plane; (3) studies published within the last three decades; and (4) written entirely in English. The exclusion criteria were: (1) studies which objective involved the verification of some aspect of validation of instruments; (2) studies published as abstracts and those published in scientific events; and (3) studies using evaluation of the anteriorization of the head to determine the angular positioning of the cervical spine. The articles in this review were included and evaluated for their methodological quality, based on the Downs and Black scale, by two independent reviewers. Initially, 1758 articles were found, 76 of which were included upon reading the full texts and 29 were included in accordance with the predetermined criteria. In addition, after analyzing the references in those articles, a further six articles were selected, so that 35 articles were included in this review. This systematic review revealed that the photogrammetry has been using in observational studies. Furthermore, it was also found that, although the data collection methodologies are similar across the studies, in relation to aspects of data analysis, the methodologies are very different, especially regarding the mathematical routines employed to support different postural evaluation software. With photogrammetry, the aim of the assessment, whether it is for clinical, research or collective health purposes, must be considered when choosing which protocol to use to evaluate spinal posture.

  1. The Estimation and Inclusion of Presenteeism Costs in Applied Economic Evaluation: A Systematic Review.

    Science.gov (United States)

    Kigozi, Jesse; Jowett, Sue; Lewis, Martyn; Barton, Pelham; Coast, Joanna

    2017-03-01

    Given the significant costs of reduced productivity (presenteeism) in comparison to absenteeism, and overall societal costs, presenteeism has a potentially important role to play in economic evaluations. However, these costs are often excluded. The objective of this study is to review applied cost of illness studies and economic evaluations to identify valuation methods used for, and impact of including presenteeism costs in practice. A structured systematic review was carried out to explore (i) the extent to which presenteeism has been applied in cost of illness studies and economic evaluations and (ii) the overall impact of including presenteeism on overall costs and outcomes. Potential articles were identified by searching Medline, PsycINFO and NHS EED databases. A standard template was developed and used to extract information from economic evaluations and cost of illness studies incorporating presenteeism costs. A total of 28 studies were included in the systematic review which also demonstrated that presenteeism costs are rarely included in full economic evaluations. Estimation and monetisation methods differed between the instruments. The impact of disease on presenteeism whilst in paid work is high. The potential impact of presenteeism costs needs to be highlighted and greater consideration should be given to including these in economic evaluations and cost of illness studies. The importance of including presenteeism costs when conducting economic evaluation from a societal perspective should be emphasised in national economic guidelines and more methodological work is required to improve the practical application of presenteeism instruments to generate productivity cost estimates. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  2. Using resource dependency theory to measure the environment in health care organizational studies: a systematic review of the literature.

    Science.gov (United States)

    Yeager, Valerie A; Menachemi, Nir; Savage, Grant T; Ginter, Peter M; Sen, Bisakha P; Beitsch, Leslie M

    2014-01-01

    Studies using the resource dependency theory (RDT) perspective commonly focus on one or more of the following environmental dimensions: munificence, dynamism, and complexity. To date, no one has reviewed the use of this theory in the health care management literature and there exists no consensus on how to operationalize the market environment in health care settings. The purpose of this review is to examine and summarize the ways in which RDT has been applied in empirical studies of the external environments of health care organizations. In so doing, we identify gaps in the literature and examine the extent to which previous empirical findings aligned with hypothesized relationships based on RDT. We conducted a systematic review of the peer-reviewed literature using a bibliographic search of PubMed and ABI/Inform databases. To identify all health care studies that incorporated the RDT perspective, the words "healthcare" or "health care" were searched in combination with any of the following words: resource dependency theory, uncertainty perspective, environment, munificence, dynamism, and complexity. We also performed a hand search of the reference lists of all manuscripts identified in the initial search to identify additional articles. Twenty studies were included in this review. Wide variability existed in the number of variables used to measure the environment, the environmental constructs measured, and the specific variables used to operationalizethe environmental constructs. Of the 198 tests examining the relationship between environmental variables and the outcome of interest, 26.8% resulted in findings that supported the RDT-predicted hypotheses. The RDT literature is limited to studies of hospitals, nursing homes, and medical practices. There is little consensus on how to measure or operationalize the environment in these studies. No previous studies have measured the environment for other health care settings such as ambulatory surgery centers, public

  3. Systematic studies of the centrality dependence of soft photon production in Au+Au collision with PHENIX

    CERN Document Server

    Bannier, Benjamin

    2014-01-01

    Since the earliest days of Heavy Ion Physics thermal soft photon radiation emitted during the reaction had been theorized as a smoking gun signal for formation of a quark-gluon plasma and as a tool to characterize its properties. In recent years the existence of excess photon radiation in heavy ion collisions over the expectation from initial hard interactions has been confirmed at both RHIC and LHC energies by PHENIX and ALICE respectively. There the radiation has been found to exhibit elliptic flow $v_2$ well above what can currently be reconciled with a picture of early emission from a plasma phase. During the 2007 and 2010 Au+Au runs PHENIX has measured a high purity sample of soft photons down to $p_T>0.4\\,\\text{GeV}/c$ using an external conversion method. We present recent systematic studies by PHENIX from that sample on the centrality dependence of the soft photon yield, and elliptic and triangular flow $v_2$ and $v_3$ in Au+Au collisions which fill in the experimental picture and enable discrimination...

  4. Systematic inference of the long-range dependence and heavy-tail distribution parameters of ARFIMA models

    Science.gov (United States)

    Watkins, Nick; Graves, Timothy; Franzke, Christian; Gramacy, Robert; Tindale, Elizabeth

    2017-04-01

    Long-Range Dependence (LRD) and heavy-tailed distributions are ubiquitous in natural and socio-economic data. Such data can be self-similar whereby both LRD and heavy-tailed distributions contribute to the self-similarity as measured by the Hurst exponent. Some methods widely used in the physical sciences separately estimate these two parameters, which can lead to estimation bias. Those which do simultaneous estimation are based on frequentist methods such as Whittle's approximate maximum likelihood estimator. Here we present a new and systematic Bayesian framework for the simultaneous inference of the LRD and heavy-tailed distribution parameters of a parametric ARFIMA model with non-Gaussian innovations. As innovations we use the alpha-stable and t-distributions which have power law tails. Our algorithm also provides parameter uncertainty estimates. We test our algorithm using synthetic data, and also data from the Geostationary Operational Environmental Satellite system (GOES) solar X-ray time series. These tests show that our algorithm is able to accurately and robustly estimate the LRD and heavy-tailed distribution parameters. See Physica A: Statistical Mechanics and its Applications, (January 2017), DOI: 10.1016/j.physa.2017.01.028

  5. Systematic inference of the long-range dependence and heavy-tail distribution parameters of ARFIMA models

    Science.gov (United States)

    Graves, Timothy; Franzke, Christian L. E.; Watkins, Nicholas W.; Gramacy, Robert B.; Tindale, Elizabeth

    2017-05-01

    Long-Range Dependence (LRD) and heavy-tailed distributions are ubiquitous in natural and socio-economic data. Such data can be self-similar whereby both LRD and heavy-tailed distributions contribute to the self-similarity as measured by the Hurst exponent. Some methods widely used in the physical sciences separately estimate these two parameters, which can lead to estimation bias. Those which do simultaneous estimation are based on frequentist methods such as Whittle's approximate maximum likelihood estimator. Here we present a new and systematic Bayesian framework for the simultaneous inference of the LRD and heavy-tailed distribution parameters of a parametric ARFIMA model with non-Gaussian innovations. As innovations we use the α-stable and t-distributions which have power law tails. Our algorithm also provides parameter uncertainty estimates. We test our algorithm using synthetic data, and also data from the Geostationary Operational Environmental Satellite system (GOES) solar X-ray time series. These tests show that our algorithm is able to accurately and robustly estimate the LRD and heavy-tailed distribution parameters.

  6. Is the evaluation of risk of bias in periodontology and implant dentistry comprehensive? A systematic review.

    Science.gov (United States)

    Faggion, Clovis Mariano; Listl, Stefan; Alarcón, Marco Antonio

    2015-05-01

    The objective of this study was to assess how authors of systematic reviews (SRs) with meta-analyses published in periodontology and implant dentistry evaluate risk of bias (ROB) in primary studies included in these reviews. A literature search for SRs with meta-analyses was performed in PubMed and Cochrane library databases up to July 20th 2014. The reference lists of included articles were screened for further reviews. The standards of evaluating ROB in primary studies were evaluated by using a 14-item checklist based on the Cochrane approach for evaluating ROB. Standards in ROB evaluations in Cochrane and paper-based SRs were compared using the Fisher's exact test. All searches, data extraction and evaluations were performed independently and in duplicate. Seventy SRs were included (45 paper-based and 25 Cochrane SRs, respectively). The median percentage of items addressed was 58% (interquartile range 4-100%). Cochrane SRs more frequently included ROB assessments than paper-based reviews in terms of examiner blinding (p = 0.0026), selective outcome reporting (p = 0.0207) and other bias (p = 0.0241). The ROB evaluation in primary studies currently included in SRs with meta-analyses in periodontology and implant dentistry is not sufficiently comprehensive. Cochrane SRs have more comprehensive ROB evaluation than paper-based reviews. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Indigenous health program evaluation design and methods in Australia: a systematic review of the evidence.

    Science.gov (United States)

    Lokuge, Kamalini; Thurber, Katherine; Calabria, Bianca; Davis, Meg; McMahon, Kathryn; Sartor, Lauren; Lovett, Raymond; Guthrie, Jill; Banks, Emily

    2017-10-01

    Indigenous Australians experience a disproportionately higher burden of disease compared to non-Indigenous Australians. High-quality evaluation of Indigenous health programs is required to inform health and health services improvement. We aimed to quantify methodological and other characteristics of Australian Indigenous health program evaluations published in the peer-reviewed literature. Systematic review of peer-reviewed literature (November 2009-2014) on Indigenous health program evaluation. We identified 118 papers describing evaluations of 109 interventions; 72.0% were university/research institution-led. 82.2% of evaluations included a quantitative component; 49.2% utilised quantitative data only and 33.1% used both quantitative and qualitative data. The most common design was a before/after comparison (30.5%, n=36/118). 7.6% of studies (n=9/118) used an experimental design: six individual-level and three cluster-randomised controlled trials. 56.8% (67/118) reported on service delivery/process outcomes (versus health or health risk factor outcomes) only. Given the number of Indigenous health programs that are implemented, few evaluations overall are published in the peer-reviewed literature and, of these, few use optimal methodologies such as mixed methods and experimental design. Implications for public health: Multiple strategies are required to increase high-quality, accessible evaluation in Indigenous health, including supporting stronger research-policy-practice partnerships and capacity building for evaluation by health services and government. © 2017 The Authors.

  8. Dietary intake in the dependent elderly: Evaluation of the risk of nutritional deficit

    OpenAIRE

    S. Fernandez-Barres; N. Martín; T. Canela; M. García-Barco; J. Basora; V. Arija

    2016-01-01

    Dietary intake in the dependent elderly: Evaluation of the risk of nutritional deficit DOI: 10.1111/jhn.12310 Background: Malnutrition is a frequent problem in elderly dependent patients and their prognosis is adversely affected. Assessment of food consumption and adequacy of energy and nutrient intake of dependent elderly is needed to plan any selected actions for this population. Methods: The study comprised a multicentre cross-sectional study of 190 users (≥65 years) of a home care p...

  9. Is There a Consensus when Physicians Evaluate the Relevance of Retrieved Systematic Reviews?

    Science.gov (United States)

    O'Sullivan, Dympna; Wilk, Szymon; Kuziemsky, Craig; Michalowski, Wojtek; Farion, Ken; Kukawka, Bartosz

    2016-05-17

    A significant challenge associated with practicing evidence-based medicine is to provide physicians with relevant clinical information when it is needed. At the same time it appears that the notion of relevance is subjective and its perception is affected by a number of contextual factors. To assess to what extent physicians agree on the relevance of evidence in the form of systematic reviews for a common set of patient cases, and to identify possible contextual factors that influence their perception of relevance. A web-based survey was used where pediatric emergency physicians from multiple academic centers across Canada were asked to evaluate the relevance of systematic reviews retrieved automatically for 14 written case vignettes (paper patients). The vignettes were derived from prospective data describing pediatric patients with asthma exacerbations presenting at the emergency department. To limit the cognitive burden on respondents, the number of reviews associated with each vignette was limited to three. Twenty-two academic emergency physicians with varying years of clinical practice completed the survey. There was no consensus in their evaluation of relevance of the retrieved reviews and physicians' assessments ranged from very relevant to irrelevant evidence, with the majority of evaluations being somewhere in the middle. This indicates that the study participants did not share a notion of relevance uniformly. Further analysis of commentaries provided by the physicians allowed identifying three possible contextual factors: expected specificity of evidence (acute vs chronic condition), the terminology used in the systematic reviews, and the micro environment of clinical setting. There is no consensus among physicians with regards to what constitutes relevant clinical evidence for a given patient case. Subsequently, this finding suggests that evidence retrieval systems should allow for deep customization with regards to physician's preferences and contextual

  10. Metal-on-metal total hip arthroplasty: risk factors for pseudotumours and clinical systematic evaluation.

    Science.gov (United States)

    Liow, Ming Han Lincoln; Kwon, Young-Min

    2017-05-01

    The potential advantages of contemporary MoM THA implants include less volumetric wear with subsequent reduction of polyethylene wear-induced osteolysis and greater component stability with use of large-diameter femoral heads. However, there have been concerns regarding significantly elevated revision rates in MoM THA due to MoM-related complications such as adverse local tissue reaction (pseudotumour) formation. The increased failure rate in MoM hip arthroplasty is associated with the generation of biologically active, nanometer sized metal particles from the MoM bearing surfaces and taper junctions, which result in the development of a localized, adverse periprosthetic soft tissue response. The focus of this article is to provide an update on (1) implant, surgical and patient factors associated with adverse local tissue reactions (pseudotumours) and (2) the clinical systematic evaluation and management of patients with MoM hip arthroplasty based on the currently available evidence. There should be a low threshold to conduct a systematic clinical evaluation of patients with MoM hip arthroplasty as early recognition and diagnosis will allow the initiation of prompt and appropriate treatment. As a symptomatic MoM total hip arthroplasty may have intrinsic and extrinsic causes, patients should be evaluated systematically, utilizing risk stratification algorithms. Although specialized laboratory tests such as metal ion levels and cross sectional imaging modalities such as MARS MRI can be used to facilitate clinical decision making, over-reliance on any single investigative tool in the clinical decision-making process should be avoided. Further research is required to obtain a better understanding of implant and patient risk factors associated with tribocorrosion in MoM total hip arthroplasty.

  11. The design, implementation, and evaluation of online credit nutrition courses: a systematic review.

    Science.gov (United States)

    Cohen, Nancy L; Carbone, Elena T; Beffa-Negrini, Patricia A

    2011-01-01

    To assess how postsecondary online nutrition education courses (ONEC) are delivered, determine ONEC effectiveness, identify theoretical models used, and identify future research needs. Systematic search of database literature. Postsecondary education. Nine research articles evaluating postsecondary ONEC. Knowledge/performance outcomes and student satisfaction, motivation, or perceptions. Systematic search of 922 articles and review of 9 articles meeting search criteria. Little research regarding ONEC marketing/management existed. Studies primarily evaluated introductory courses using email/websites (before 2000), or course management systems (after 2002). None used true experimental designs; just 3 addressed validity or reliability of measures or pilot-tested instruments. Three articles used theoretical models in course design; few used theories to guide evaluations. Four quasi-experimental studies indicated no differences in nutrition knowledge/performance between online and face-to-face learners. Results were inconclusive regarding student satisfaction, motivation, or perceptions. Students can gain knowledge in online as well as in face-to-face nutrition courses, but satisfaction was mixed. More up-to-date investigations on effective practices are warranted, using theories to identify factors that enhance student outcomes, addressing emerging technologies, and documenting ONEC marketing, management, and delivery. Adequate training/support for faculty is needed to improve student experiences and faculty time management. Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

  12. Systematic Review of Empirically Evaluated School-Based Gambling Education Programs.

    Science.gov (United States)

    Keen, Brittany; Blaszczynski, Alex; Anjoul, Fadi

    2017-03-01

    Adolescent problem gambling prevalence rates are reportedly five times higher than in the adult population. Several school-based gambling education programs have been developed in an attempt to reduce problem gambling among adolescents; however few have been empirically evaluated. The aim of this review was to report the outcome of studies empirically evaluating gambling education programs across international jurisdictions. A systematic review following guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement searching five academic databases: PubMed, Scopus, Medline, PsycINFO, and ERIC, was conducted. A total of 20 papers and 19 studies were included after screening and exclusion criteria were applied. All studies reported intervention effects on cognitive outcomes such as knowledge, perceptions, and beliefs. Only nine of the studies attempted to measure intervention effects on behavioural outcomes, and only five of those reported significant changes in gambling behaviour. Of these five, methodological inadequacies were commonly found including brief follow-up periods, lack of control comparison in post hoc analyses, and inconsistencies and misclassifications in the measurement of gambling behaviour, including problem gambling. Based on this review, recommendations are offered for the future development and evaluation of school-based gambling education programs relating to both methodological and content design and delivery considerations.

  13. A systematic review of economic evaluations of treatments for borderline personality disorder.

    Directory of Open Access Journals (Sweden)

    Christian Brettschneider

    Full Text Available PURPOSE: The borderline personality disorder is a common mental disorder. It is frequently associated with various mental co-morbidities and a fundamental loss of functioning. The borderline personality disorder causes high costs to society. The aim of this study was to perform a systematic literature review of existing economic evaluations of treatments for borderline personality disorder. MATERIALS AND METHODS: We performed a systematic literature search in MEDLINE, EMBASE, PsycINFO and NHSEED for partial and full economic evaluations regarding borderline personality disorder. Reported cost data were inflated to the year 2012 and converted into US-$ using purchasing power parities to allow for comparability. Quality assessment of the studies was performed by means of the Consensus on Health Economic Criteria checklist, a checklist developed by a Delphi method in cooperation with 23 international experts. RESULTS: We identified 6 partial and 9 full economic evaluations. The methodical quality was moderate (fulfilled quality criteria: 79.2% [SD: 15.4%] in partial economic evaluations, 77.3% [SD: 8.5%] in full economic evaluations. Most evaluations analysed psychotherapeutic interventions. Although ambiguous, most evidence exists on dialectical-behavioural therapy. Cognitive behavioural therapy and schema-focused therapy are cost-saving. Evidence on other interventions is scarce. CONCLUSION: The economic evidence is not sufficient to draw robust conclusions for all treatments. It is possible that some treatments are cost-effective. Most evidence exists on dialectical-behavioural therapy. Yet, it is ambiguous. Further research concerning the cost-effectiveness of treatments is necessary as well as the identification of relevant cost categories and the validation of effect measures.

  14. School-based counseling using systematic feedback: a cohort study evaluating outcomes and predictors of change.

    Science.gov (United States)

    Cooper, Mick; Stewart, Dave; Sparks, Jacqueline; Bunting, Lisa

    2013-01-01

    The outcomes of school-based counseling incorporating the Partners for Change Outcome Monitoring System (PCOMS) were evaluated using a cohort design, with multilevel modeling to identify predictors of change. Participants were 288 7-11 year olds experiencing social, emotional or behavioral difficulties. The intervention was associated with significant reductions in psychological distress, with a pre-post effect size (d) of 1.49 on the primary outcome measure and 88.7% clinical improvement. Greater improvements were found for disabled children, older children, and where CBT methods were used. The findings provide support for the use of systematic feedback in therapy with children.

  15. A systematic evaluation of the quality of meta-analyses in endodontics.

    Science.gov (United States)

    Suebnukarn, Siriwan; Ngamboonsirisingh, Sureeporn; Rattanabanlang, Angwara

    2010-04-01

    Meta-analyses have been suggested to be the highest form of evidence available to clinicians to guide clinical practice in dental care. High methodologic quality is a prerequisite for valid interpretation and application of review findings. However, meta-analyses are complex exercises, and assessing quality can be a daunting task. Clinicians and policymakers require guidance, which is not provided adequately by the available literature on the quality of meta-analyses. The purpose of this study was to systematically evaluate the quality of meta-analyses that address topics pertinent to endodontics. To identify potentially eligible meta-analyses for inclusion, systematic searches performed in MEDLINE and the Cochrane Database of Systematic Reviews were enriched by hand searches, citation mining, and expert recommendation. Comprehensive search strategies were constructed for electronic searches. Predetermined inclusion criteria were applied to each identified meta-analysis independently by two reviewers. To assess report quality, the included meta-analyses were assessed by using A Measurement Tool to Assess Systematic Reviews (AMSTAR). A total of 16 reports of meta-analyses were included (kappa = 0.96). The overall quality of reports of meta-analyses was found to be high, with an estimated mean overall AMSTAR score of 8.33 out of 11 (95% confidence interval, 7.62-8.88). The weakest areas within the included meta-analyses were failure to report the likelihood of publication bias. The overall quality of the reports of meta-analyses available in endodontics is high according to AMSTAR. Copyright (c) 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  16. Systematic Charge-to-Mass-Dependence of Heavy Ion Spectral Breaks in Large Gradual Solar Energetic Particle Events

    Science.gov (United States)

    Desai, Mihir; Mason, Glenn; McComas, David; Cohen, Christina; Smith, Charles; Ebert, Robert; Schwadron, Nathan; Li, Gang; Mewaldt, Richard; Dayeh, Maher A.

    2016-07-01

    We fit the ˜0.1-500 MeV/nucleon H-Fe spectra in 46 large SEP events surveyed by Desai et al. (2015) with the double power-law Band function to obtain a normalization constant, low- and high-energy Band parameters γ_a and γ_b; and spectral break energy E_B. We also calculate the low-energy power-law spectral slope γ_1. Our results are: 1) γ_a, γ_1, and γ_b are species-independent and the spectra steepen with increasing energy; 2) the low-energy power-law spectral slopes γ_1 are consistent with diffusive acceleration at shocks with compression ratios between ˜2-4 as predicted by Schwadron et al. (2015); 3) the spectral breaks E_B's are well ordered by Q/M ratio, and decrease systematically with decreasing Q/M, scaling as (Q/M)^α with α in most events varying between ˜0.2-2, as predicted by Li et al (2009); 4) α is well correlated with Fe/O at ˜0.16-0.23 MeV/nucleon, but not with the ˜15-21 MeV/nucleon Fe/O and the ˜0.5-2.0 MeV/nucleon ^3He/^4He ratios; 5) In most events: α3, and O E_B increases with γ_b - γ_a; and 6) Many extreme events (associated with faster CMEs and GLEs) are Fe-rich and ^3He-rich, have α≳1.4, flatter spectra at low and high energies with γ_b - γ_a <3, and E_B that anti-correlates with γ_b - γ_a. In most events, the Q/M-dependence of E_B is consistent with the equal diffusion coefficient condition, while the event-to-event variations in α may be driven by differences in the near-shock wave intensity spectra, which are flatter than the Kolmogorov turbulence spectrum but weaker when than extreme events. We interpret these results as being due to weaker turbulence that allows the SEPs to easily escape, resulting in weaker Q/M-dependence of E_B, lower α values, and spectral steepening at higher energies. In contrast for extreme events, the stronger Q/M-dependence of E_B, larger α values, and harder spectra at high and low energy occur because enhanced wave power enables faster CME shocks to accelerate flare suprathermals

  17. Evaluating communities of practice and knowledge networks: a systematic scoping review of evaluation frameworks.

    Science.gov (United States)

    McKellar, Kaileah A; Pitzul, Kristen B; Yi, Juliana Y; Cole, Donald C

    2014-09-01

    Communities of Practice (CoPs) are increasingly considered a part of ecohealth and other sectors such as health care, education, and business. However, there is little agreement on approaches to evaluate the influence and effectiveness of CoPs. The purpose of this review was to understand what frameworks and methods have been proposed or used to evaluate CoPs and/or knowledge networks. The review searched electronic databases in interdisciplinary, health, education, and business fields, and further collected references and forward citations from relevant articles. Nineteen articles with 16 frameworks were included in the synthesis. The purposes of the evaluation frameworks varied; while some focused on assessing the performance of CoPs, several frameworks sought to learn about CoPs and their critical success factors. Nine of the frameworks had been applied or tested in some way, most frequently to guide a case study. With limited applications of the frameworks, strong claims about generalizability could not be made. The review results can inform the development of tailored frameworks. However, there is a need for more detailed and targeted CoP evaluation frameworks, as many imperative CoP evaluation needs would be unmet by the available frameworks.

  18. A systematic review of economic evaluations of health and health-related interventions in Bangladesh.

    Science.gov (United States)

    Hoque, Mohammad E; Khan, Jahangir Am; Hossain, Shahed Sa; Gazi, Rukhsana; Rashid, Harun-Ar; Koehlmoos, Tracey P; Walker, Damian G

    2011-07-20

    Economic evaluation is used for effective resource allocation in health sector. Accumulated knowledge about economic evaluation of health programs in Bangladesh is not currently available. While a number of economic evaluation studies have been performed in Bangladesh, no systematic investigation of the studies has been done to our knowledge. The aim of this current study is to systematically review the published articles in peer-reviewed journals on economic evaluation of health and health-related interventions in Bangladesh. Literature searches was carried out during November-December 2008 with a combination of key words, MeSH terms and other free text terms as suitable for the purpose. A comprehensive search strategy was developed to search Medline by the PubMed interface. The first specific interest was mapping the articles considering the areas of exploration by economic evaluation and the second interest was to scrutiny the methodological quality of studies. The methodological quality of economic evaluation of all articles has been scrutinized against the checklist developed by Evers Silvia and associates. Of 1784 potential articles 12 were accepted for inclusion. Ten studies described the competing alternatives clearly and only two articles stated the perspective of their articles clearly. All studies included direct cost, incurred by the providers. Only one study included the cost of community donated resources and volunteer costs. Two studies calculated the incremental cost effectiveness ratio (ICER). Six of the studies applied some sort of sensitivity analysis. Two of the studies discussed financial affordability of expected implementers and four studies discussed the issue of generalizability for application in different context. Very few economic evaluation studies in Bangladesh are found in different areas of health and health-related interventions, which does not provide a strong basis of knowledge in the area. The most frequently applied economic

  19. A systematic review of economic evaluations of health and health-related interventions in Bangladesh

    Directory of Open Access Journals (Sweden)

    Koehlmoos Tracey P

    2011-07-01

    Full Text Available Abstract Background Economic evaluation is used for effective resource allocation in health sector. Accumulated knowledge about economic evaluation of health programs in Bangladesh is not currently available. While a number of economic evaluation studies have been performed in Bangladesh, no systematic investigation of the studies has been done to our knowledge. The aim of this current study is to systematically review the published articles in peer-reviewed journals on economic evaluation of health and health-related interventions in Bangladesh. Methods Literature searches was carried out during November-December 2008 with a combination of key words, MeSH terms and other free text terms as suitable for the purpose. A comprehensive search strategy was developed to search Medline by the PubMed interface. The first specific interest was mapping the articles considering the areas of exploration by economic evaluation and the second interest was to scrutiny the methodological quality of studies. The methodological quality of economic evaluation of all articles has been scrutinized against the checklist developed by Evers Silvia and associates. Result Of 1784 potential articles 12 were accepted for inclusion. Ten studies described the competing alternatives clearly and only two articles stated the perspective of their articles clearly. All studies included direct cost, incurred by the providers. Only one study included the cost of community donated resources and volunteer costs. Two studies calculated the incremental cost effectiveness ratio (ICER. Six of the studies applied some sort of sensitivity analysis. Two of the studies discussed financial affordability of expected implementers and four studies discussed the issue of generalizability for application in different context. Conclusion Very few economic evaluation studies in Bangladesh are found in different areas of health and health-related interventions, which does not provide a strong basis

  20. A Systematic Review of Reviews Evaluating Technology-Enabled Diabetes Self-Management Education and Support.

    Science.gov (United States)

    Greenwood, Deborah A; Gee, Perry M; Fatkin, Kathy J; Peeples, Malinda

    2017-09-01

    Since the introduction of mobile phones, technology has been increasingly used to enable diabetes self-management education and support. This timely systematic review summarizes how currently available technology impacts outcomes for people living with diabetes. A systematic review of high quality review articles and meta analyses focused on utilizing technology in diabetes self-management education and support services was conducted. Articles were included if published between January 2013 and January 2017. Twenty-five studies were included for analysis. The majority evaluated the use of mobile phones and secure messaging. Most studies described healthy eating, being active and metabolic monitoring as the predominant self-care behaviors evaluated. Eighteen of 25 reviews reported significant reduction in A1c as an outcome measure. Four key elements emerged as essential for improved A1c: (1) communication, (2) patient-generated health data, (3) education, and (4) feedback. Technology-enabled diabetes self-management solutions significantly improve A1c. The most effective interventions incorporated all the components of a technology-enabled self-management feedback loop that connected people with diabetes and their health care team using 2-way communication, analyzed patient-generated health data, tailored education, and individualized feedback. The evidence from this systematic review indicates that organizations, policy makers and payers should consider integrating these solutions in the design of diabetes self-management education and support services for population health and value-based care models. With the widespread adoption of mobile phones, digital health solutions that incorporate evidence-based, behaviorally designed interventions can improve the reach and access to diabetes self-management education and ongoing support.

  1. Evaluation of angle-dependent absorption: Computer simulation and listening test for an objective and subjective evaluation

    OpenAIRE

    Vázquez Rufino, David

    2013-01-01

    The aim of this thesis is the subjective and objective evaluation of angledependent absorption coefficients. As the assumption of a constant absorption coefficient over the angle of incidence is not always held, a new model acknowledging an angle-dependent reflection must be considered, to get a more accurate prediction in the sound field. The study provides information about the behavior of different materials in several rooms, depending on the reflection modeling of incident sound waves....

  2. A systematic assessment of MHC class II peptide binding predictions and evaluation of a consensus approach.

    Directory of Open Access Journals (Sweden)

    Peng Wang

    2008-04-01

    Full Text Available The identification of MHC class II restricted peptide epitopes is an important goal in immunological research. A number of computational tools have been developed for this purpose, but there is a lack of large-scale systematic evaluation of their performance. Herein, we used a comprehensive dataset consisting of more than 10,000 previously unpublished MHC-peptide binding affinities, 29 peptide/MHC crystal structures, and 664 peptides experimentally tested for CD4+ T cell responses to systematically evaluate the performances of publicly available MHC class II binding prediction tools. While in selected instances the best tools were associated with AUC values up to 0.86, in general, class II predictions did not perform as well as historically noted for class I predictions. It appears that the ability of MHC class II molecules to bind variable length peptides, which requires the correct assignment of peptide binding cores, is a critical factor limiting the performance of existing prediction tools. To improve performance, we implemented a consensus prediction approach that combines methods with top performances. We show that this consensus approach achieved best overall performance. Finally, we make the large datasets used publicly available as a benchmark to facilitate further development of MHC class II binding peptide prediction methods.

  3. Economic evaluation of pediatric influenza immunization program compared with other pediatric immunization programs: A systematic review

    Science.gov (United States)

    Gibson, Edward; Begum, Najida; Sigmundsson, Birgir; Sackeyfio, Alfred; Hackett, Judith; Rajaram, Sankarasubramanian

    2016-01-01

    ABSTRACT This study compared the economic value of pediatric immunisation programmes for influenza to those for rotavirus (RV), meningococcal disease (MD), pneumococcal disease (PD), human papillomavirus (HPV), hepatitis B (Hep B), and varicella reported in recent (2000 onwards) cost-effectiveness (CE) studies identified in a systematic review of PubMed, health technology, and vaccination databases. The systematic review yielded 51 economic evaluation studies of pediatric immunisation — 10 (20%) for influenza and 41 (80%) for the other selected diseases. The quality of the eligible articles was assessed using Drummond's checklist. Although inherent challenges and limitations exist when comparing economic evaluations of immunisation programmes, an overall comparison of the included studies demonstrated cost-effectiveness/cost saving for influenza from a European-Union-Five (EU5) and United States (US) perspective; point estimates for cost/quality-adjusted life-years (QALY) from dominance (cost-saving with more effect) to ≤45,444 were reported. The economic value of influenza programmes was comparable to the other vaccines of interest, with cost/QALY in general considerably lower than RV, Hep B, MD and PD. Independent of the perspective and type of analysis, the economic impact of a pediatric influenza immunisation program was influenced by vaccine efficacy, immunisation coverage, costs, and most significantly by herd immunity. This review suggests that pediatric influenza immunisation may offer a cost effective strategy when compared with HPV and varicella and possibly more value compared with other childhood vaccines (RV, Hep B, MD and PD). PMID:26837602

  4. What is actually measured in process evaluations for worksite health promotion programs: a systematic review

    Science.gov (United States)

    2013-01-01

    Background Numerous worksite health promotion program (WHPPs) have been implemented the past years to improve employees’ health and lifestyle (i.e., physical activity, nutrition, smoking, alcohol use and relaxation). Research primarily focused on the effectiveness of these WHPPs. Whereas process evaluations provide essential information necessary to improve large scale implementation across other settings. Therefore, this review aims to: (1) further our understanding of the quality of process evaluations alongside effect evaluations for WHPPs, (2) identify barriers/facilitators affecting implementation, and (3) explore the relationship between effectiveness and the implementation process. Methods Pubmed, EMBASE, PsycINFO, and Cochrane (controlled trials) were searched from 2000 to July 2012 for peer-reviewed (randomized) controlled trials published in English reporting on both the effectiveness and the implementation process of a WHPP focusing on physical activity, smoking cessation, alcohol use, healthy diet and/or relaxation at work, targeting employees aged 18-65 years. Results Of the 307 effect evaluations identified, twenty-two (7.2%) published an additional process evaluation and were included in this review. The results showed that eight of those studies based their process evaluation on a theoretical framework. The methodological quality of nine process evaluations was good. The most frequently reported process components were dose delivered and dose received. Over 50 different implementation barriers/facilitators were identified. The most frequently reported facilitator was strong management support. Lack of resources was the most frequently reported barrier. Seven studies examined the link between implementation and effectiveness. In general a positive association was found between fidelity, dose and the primary outcome of the program. Conclusions Process evaluations are not systematically performed alongside effectiveness studies for WHPPs. The quality

  5. How Do Type Ia Supernova Nebular Spectra Depend on Explosion Properties? Insights from Systematic Non-LTE Modeling

    Science.gov (United States)

    Botyánszki, János; Kasen, Daniel

    2017-08-01

    We present a radiative transfer code to model the nebular phase spectra of supernovae (SNe) in non-LTE (NLTE). We apply it to a systematic study of SNe Ia using parameterized 1D models and show how nebular spectral features depend on key physical parameters, such as the time since explosion, total ejecta mass, kinetic energy, radial density profile, and the masses of 56Ni, intermediate-mass elements, and stable iron-group elements. We also quantify the impact of uncertainties in atomic data inputs. We find the following. (1) The main features of SN Ia nebular spectra are relatively insensitive to most physical parameters. Degeneracy among parameters precludes a unique determination of the ejecta properties from spectral fitting. In particular, features can be equally well fit with generic Chandrasekhar mass ({M}{ch}), sub-{M}{Ch}, and super-{M}{Ch} models. (2) A sizable (≳0.1 {M}⊙ ) central region of stable iron-group elements, often claimed as evidence for {M}{Ch} models, is not essential to fit the optical spectra and may produce an unusual flat-top [Co iii] profile. (3) The strength of [S iii] emission near 9500 Å can provide a useful diagnostic of explosion nucleosynthesis. (4) Substantial amounts (≳0.1 {M}⊙ ) of unburned C/O mixed throughout the ejecta produce [O iii] emission not seen in observations. (5) Shifts in the wavelength of line peaks can arise from line-blending effects. (6) The steepness of the ejecta density profile affects the line shapes, offering a constraint on explosion models. (7) Uncertainties in atomic data limit the ability to infer physical parameters.

  6. A systematic and critical review of model-based economic evaluations of pharmacotherapeutics in patients with bipolar disorder.

    Science.gov (United States)

    Mohiuddin, Syed

    2014-08-01

    Bipolar disorder (BD) is a chronic and relapsing mental illness with a considerable health-related and economic burden. The primary goal of pharmacotherapeutics for BD is to improve patients' well-being. The use of decision-analytic models is key in assessing the added value of the pharmacotherapeutics aimed at treating the illness, but concerns have been expressed about the appropriateness of different modelling techniques and about the transparency in the reporting of economic evaluations. This paper aimed to identify and critically appraise published model-based economic evaluations of pharmacotherapeutics in BD patients. A systematic review combining common terms for BD and economic evaluation was conducted in MEDLINE, EMBASE, PSYCINFO and ECONLIT. Studies identified were summarised and critically appraised in terms of the use of modelling technique, model structure and data sources. Considering the prognosis and management of BD, the possible benefits and limitations of each modelling technique are discussed. Fourteen studies were identified using model-based economic evaluations of pharmacotherapeutics in BD patients. Of these 14 studies, nine used Markov, three used discrete-event simulation (DES) and two used decision-tree models. Most of the studies (n = 11) did not include the rationale for the choice of modelling technique undertaken. Half of the studies did not include the risk of mortality. Surprisingly, no study considered the risk of having a mixed bipolar episode. This review identified various modelling issues that could potentially reduce the comparability of one pharmacotherapeutic intervention with another. Better use and reporting of the modelling techniques in the future studies are essential. DES modelling appears to be a flexible and comprehensive technique for evaluating the comparability of BD treatment options because of its greater flexibility of depicting the disease progression over time. However, depending on the research question

  7. Qualitative Evaluation Methods in Ethics Education: A Systematic Review and Analysis of Best Practices.

    Science.gov (United States)

    Watts, Logan L; Todd, E Michelle; Mulhearn, Tyler J; Medeiros, Kelsey E; Mumford, Michael D; Connelly, Shane

    2017-01-01

    Although qualitative research offers some unique advantages over quantitative research, qualitative methods are rarely employed in the evaluation of ethics education programs and are often criticized for a lack of rigor. This systematic review investigated the use of qualitative methods in studies of ethics education. Following a review of the literature in which 24 studies were identified, each study was coded based on 16 best practices characteristics in qualitative research. General thematic analysis and grounded theory were found to be the dominant approaches used. Researchers are effectively executing a number of best practices, such as using direct data sources, structured data collection instruments, non-leading questioning, and expert raters. However, other best practices were rarely present in the courses reviewed, such as collecting data using multiple sources, methods, raters, and timepoints, evaluating reliability, and employing triangulation analyses to assess convergence. Recommendations are presented for improving future qualitative research studies in ethics education.

  8. Road safety effects of porous asphalt: a systematic review of evaluation studies

    DEFF Research Database (Denmark)

    Elvik, R.; Greibe, Poul

    2005-01-01

    This paper presents a systematic review of studies that have evaluated the effects on road safety of porous asphalt. Porous asphalt is widely used on motorways in Europe, mainly in order to reduce traffic noise and increase road capacity. A meta-analysis was made of six studies, containing a total...... of eighteen estimates of the effect of porous asphalt on accident rates. No clear effect on road safety of porous asphalt was found. All summary estimates of effect indicated very small changes in accident rates and very few were statistically significant at conventional levels. Studies that have evaluated...... of these changes in risk factors on accident occurrence cannot be predicted. On the whole, the research that has been reported so far regarding road safety effects of porous asphalt is inconclusive. The studies are not of high quality and the findings are inconsistent....

  9. The Systematic Evaluation of Instruments Designed to Assess Pain in Persons with Limited Ability to Communicate*

    Directory of Open Access Journals (Sweden)

    Michèle Aubin

    2007-01-01

    Full Text Available Chronic pain is often underdetected and undertreated in long-term care facilities. The use of self-report measures of pain (such as the visual analogue scale is often problematic for older adults residing in long-term care because of the high prevalence of visual and auditory deficits and severe cognitive impairment. Observational measures of pain have been developed to address this concern. A systematic grid designed to assess the properties of existing observational measures of pain was used for seniors with dementia. The grid focused on the evaluation of content validity (12 items, construct validity (12 items, reliability (13 items and clinical utility (10 items. Among the 24 instruments that were evaluated, several were deemed to be promising in the assessment of pain among older persons with severe dementia. Nonetheless, additional research is needed before their routine integration in the practices of long-term care settings.

  10. Evaluation of Implant Collar Surfaces for Marginal Bone Loss: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Koodaryan, Roodabeh; Hafezeqoran, Ali

    2016-01-01

    Background. It is important to understand the influence of different collar designs on peri-implant marginal bone loss, especially in the critical area. Objectives. The purpose of the present systematic review and meta-analysis was to compare dental implants with different collar surfaces, evaluating marginal bone loss and survival rates of implants. Methods. Eligibility criteria included clinical human studies, randomized controlled trials, and prospective and retrospective studies, which evaluated dental implants with different collar surface in the same study. Results. Twelve articles were included, with a total of 492 machined, 319 rough-surfaced, and 352 rough-surfaced microthreaded neck implants. There was less marginal bone loss at implants with rough-surfaced and rough-surfaced microthreaded neck than at machined-neck implants (difference in means: 0.321, 95% CI: 0.149 to 0.493; p bone loss.

  11. [Systematic evaluation of retention behavior of carbohydrates in hydrophilic interaction liquid chromatography].

    Science.gov (United States)

    Fu, Qing; Wang, Jun; Liang, Tu; Xu, Xiaoyong; Jin, Yu

    2013-11-01

    A systematic evaluation of retention behavior of carbohydrates in hydrophilic interaction liquid chromatography (HILIC) was performed. The influences of mobile phase, stationary phase and buffer salt on the retention of carbohydrates were investigated. According to the results, the retention time of carbohydrates decreased as the proportion of acetonitrile in mobile phase decreased. Increased time of carbohydrates was observed as the concentration of buffer salt in mobile phase increased. The retention behavior of carbohydrates was also affected by organic solvent and HILIC stationary phase. Furthermore, an appropriate retention equation was used in HILIC mode. The retention equation lnk = a + blnC(B) + cC(B) could quantitatively describe the retention factors of carbohydrates of plant origin with good accuracy: the relative error of the predicted time to actual time was less than 0.3%. The evaluation results could provide guidance for carbohydrates to optimize the experimental conditions in HILIC method development especially for carbohydrate separation

  12. Systematic iteration between model and methodology: A proposed approach to evaluating unintended consequences.

    Science.gov (United States)

    Morell, Jonathan A

    2017-09-18

    This article argues that evaluators could better deal with unintended consequences if they improved their methods of systematically and methodically combining empirical data collection and model building over the life cycle of an evaluation. This process would be helpful because it can increase the timespan from when the need for a change in methodology is first suspected to the time when the new element of the methodology is operational. The article begins with an explanation of why logic models are so important in evaluation, and why the utility of models is limited if they are not continually revised based on empirical evaluation data. It sets the argument within the larger context of the value and limitations of models in the scientific enterprise. Following will be a discussion of various issues that are relevant to model development and revision. What is the relevance of complex system behavior for understanding predictable and unpredictable unintended consequences, and the methods needed to deal with them? How might understanding of unintended consequences be improved with an appreciation of generic patterns of change that are independent of any particular program or change effort? What are the social and organizational dynamics that make it rational and adaptive to design programs around single-outcome solutions to multi-dimensional problems? How does cognitive bias affect our ability to identify likely program outcomes? Why is it hard to discern change as a result of programs being embedded in multi-component, continually fluctuating, settings? The last part of the paper outlines a process for actualizing systematic iteration between model and methodology, and concludes with a set of research questions that speak to how the model/data process can be made efficient and effective. Copyright © 2017. Published by Elsevier Ltd.

  13. Evaluating clinical ethics support in mental healthcare: a systematic literature review.

    Science.gov (United States)

    Hem, Marit Helene; Pedersen, Reidar; Norvoll, Reidun; Molewijk, Bert

    2015-06-01

    A systematic literature review on evaluation of clinical ethics support services in mental healthcare is presented and discussed. The focus was on (a) forms of clinical ethics support services, (b) evaluation of clinical ethics support services, (c) contexts and participants and (d) results. Five studies were included. The ethics support activities described were moral case deliberations and ethics rounds. Different qualitative and quantitative research methods were utilized. The results show that (a) participants felt that they gained an increased insight into moral issues through systematic reflection; (b) there was improved cooperation among multidisciplinary team members; (c) it was uncertain whether clinical ethics support services led to better patient care; (d) the issue of patient and client participation is complex; and (e) the implementation process is challenging. Clinical ethics support services have mainly been studied through the experiences of the participating facilitators and healthcare professionals. Hence, there is limited knowledge of whether and how various types of clinical ethics support services influence the quality of care and how patients and relatives may evaluate clinical ethics support services. Based on the six excluded 'grey zone articles', in which there was an implicit focus on ethics reflection, other ways of working with ethical reflection in practice are discussed. Implementing and evaluating clinical ethics support services as approaches to clinical ethics support that are more integrated into the development of good practice are in focus. In order to meet some of the shortcomings of the field of clinical ethics support services, a research project that aims to strengthen ethics support in the mental health services, including patients' and caregivers' views on ethical challenges, is presented. © The Author(s) 2014.

  14. A systematic review evaluating the psychometric properties of measures of social inclusion.

    Science.gov (United States)

    Cordier, Reinie; Milbourn, Ben; Martin, Robyn; Buchanan, Angus; Chung, Donna; Speyer, Renée

    2017-01-01

    Improving social inclusion opportunities for population health has been identified as a priority area for international policy. There is a need to comprehensively examine and evaluate the quality of psychometric properties of measures of social inclusion that are used to guide social policy and outcomes. To conduct a systematic review of the literature on all current measures of social inclusion for any population group, to evaluate the quality of the psychometric properties of identified measures, and to evaluate if they capture the construct of social inclusion. A systematic search was performed using five electronic databases: CINAHL, PsycINFO, Embase, ERIC and Pubmed and grey literature were sourced to identify measures of social inclusion. The psychometric properties of the social inclusion measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. Of the 109 measures identified, twenty-five measures, involving twenty-five studies and one manual met the inclusion criteria. The overall quality of the reviewed measures was variable, with the Social and Community Opportunities Profile-Short, Social Connectedness Scale and the Social Inclusion Scale demonstrating the strongest evidence for sound psychometric quality. The most common domain included in the measures was connectedness (21), followed by participation (19); the domain of citizenship was covered by the least number of measures (10). No single instrument measured all aspects within the three domains of social inclusion. Of the measures with sound psychometric evidence, the Social and Community Opportunities Profile-Short captured the construct of social inclusion best. The overall quality of the psychometric properties demonstrate that the current suite of available instruments for the measurement of social inclusion are promising but need further refinement. There is a need for a universal working definition of social inclusion as an overarching

  15. A systematic review evaluating the psychometric properties of measures of social inclusion

    Science.gov (United States)

    Milbourn, Ben; Martin, Robyn; Buchanan, Angus; Chung, Donna; Speyer, Renée

    2017-01-01

    Introduction Improving social inclusion opportunities for population health has been identified as a priority area for international policy. There is a need to comprehensively examine and evaluate the quality of psychometric properties of measures of social inclusion that are used to guide social policy and outcomes. Objective To conduct a systematic review of the literature on all current measures of social inclusion for any population group, to evaluate the quality of the psychometric properties of identified measures, and to evaluate if they capture the construct of social inclusion. Methods A systematic search was performed using five electronic databases: CINAHL, PsycINFO, Embase, ERIC and Pubmed and grey literature were sourced to identify measures of social inclusion. The psychometric properties of the social inclusion measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. Results Of the 109 measures identified, twenty-five measures, involving twenty-five studies and one manual met the inclusion criteria. The overall quality of the reviewed measures was variable, with the Social and Community Opportunities Profile-Short, Social Connectedness Scale and the Social Inclusion Scale demonstrating the strongest evidence for sound psychometric quality. The most common domain included in the measures was connectedness (21), followed by participation (19); the domain of citizenship was covered by the least number of measures (10). No single instrument measured all aspects within the three domains of social inclusion. Of the measures with sound psychometric evidence, the Social and Community Opportunities Profile-Short captured the construct of social inclusion best. Conclusions The overall quality of the psychometric properties demonstrate that the current suite of available instruments for the measurement of social inclusion are promising but need further refinement. There is a need for a universal working

  16. Economic Evaluation of Interventions for Prevention of Hospital Acquired Infections: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Habibollah Arefian

    Full Text Available This systematic review sought to assess the costs and benefits of interventions preventing hospital-acquired infections and to evaluate methodological and reporting quality.We systematically searched Medline via PubMed and the National Health Service Economic Evaluation Database from 2009 to 2014. We included quasi-experimental and randomized trails published in English or German evaluating the economic impact of interventions preventing the four most frequent hospital-acquired infections (urinary tract infections, surgical wound infections, pneumonia, and primary bloodstream infections. Characteristics and results of the included articles were extracted using a standardized data collection form. Study and reporting quality were evaluated using SIGN and CHEERS checklists. All costs were adjusted to 2013 US$. Savings-to-cost ratios and difference values with interquartile ranges (IQRs per month were calculated, and the effects of study characteristics on the cost-benefit results were analyzed.Our search returned 2067 articles, of which 27 met the inclusion criteria. The median savings-to-cost ratio across all studies reporting both costs and savings values was US $7.0 (IQR 4.2-30.9, and the median net global saving was US $13,179 (IQR 5,106-65,850 per month. The studies' reporting quality was low. Only 14 articles reported more than half of CHEERS items appropriately. Similarly, an assessment of methodological quality found that only four studies (14.8% were considered high quality.Prevention programs for hospital acquired infections have very positive cost-benefit ratios. Improved reporting quality in health economics publications is required.

  17. Does the GPM mission improve the systematic error component in satellite rainfall estimates over TRMM? An evaluation at a pan-India scale

    Directory of Open Access Journals (Sweden)

    H. Beria

    2017-12-01

    Full Text Available The last couple of decades have seen the outburst of a number of satellite-based precipitation products with Tropical Rainfall Measuring Mission (TRMM as the most widely used for hydrologic applications. Transition of TRMM into the Global Precipitation Measurement (GPM promises enhanced spatio-temporal resolution along with upgrades to sensors and rainfall estimation techniques. The dependence of systematic error components in rainfall estimates of the Integrated Multi-satellitE Retrievals for GPM (IMERG, and their variation with climatology and topography, was evaluated over 86 basins in India for year 2014 and compared with the corresponding (2014 and retrospective (1998–2013 TRMM estimates. IMERG outperformed TRMM for all rainfall intensities across a majority of Indian basins, with significant improvement in low rainfall estimates showing smaller negative biases in 75 out of 86 basins. Low rainfall estimates in TRMM showed a systematic dependence on basin climatology, with significant overprediction in semi-arid basins, which gradually improved in the higher rainfall basins. Medium and high rainfall estimates of TRMM exhibited a strong dependence on basin topography, with declining skill in higher elevation basins. The systematic dependence of error components on basin climatology and topography was reduced in IMERG, especially in terms of topography. Rainfall-runoff modeling using the Variable Infiltration Capacity (VIC model over two flood-prone basins (Mahanadi and Wainganga revealed that improvement in rainfall estimates in IMERG did not translate into improvement in runoff simulations. More studies are required over basins in different hydroclimatic zones to evaluate the hydrologic significance of IMERG.

  18. Does the GPM mission improve the systematic error component in satellite rainfall estimates over TRMM? An evaluation at a pan-India scale

    Science.gov (United States)

    Beria, Harsh; Nanda, Trushnamayee; Singh Bisht, Deepak; Chatterjee, Chandranath

    2017-12-01

    The last couple of decades have seen the outburst of a number of satellite-based precipitation products with Tropical Rainfall Measuring Mission (TRMM) as the most widely used for hydrologic applications. Transition of TRMM into the Global Precipitation Measurement (GPM) promises enhanced spatio-temporal resolution along with upgrades to sensors and rainfall estimation techniques. The dependence of systematic error components in rainfall estimates of the Integrated Multi-satellitE Retrievals for GPM (IMERG), and their variation with climatology and topography, was evaluated over 86 basins in India for year 2014 and compared with the corresponding (2014) and retrospective (1998-2013) TRMM estimates. IMERG outperformed TRMM for all rainfall intensities across a majority of Indian basins, with significant improvement in low rainfall estimates showing smaller negative biases in 75 out of 86 basins. Low rainfall estimates in TRMM showed a systematic dependence on basin climatology, with significant overprediction in semi-arid basins, which gradually improved in the higher rainfall basins. Medium and high rainfall estimates of TRMM exhibited a strong dependence on basin topography, with declining skill in higher elevation basins. The systematic dependence of error components on basin climatology and topography was reduced in IMERG, especially in terms of topography. Rainfall-runoff modeling using the Variable Infiltration Capacity (VIC) model over two flood-prone basins (Mahanadi and Wainganga) revealed that improvement in rainfall estimates in IMERG did not translate into improvement in runoff simulations. More studies are required over basins in different hydroclimatic zones to evaluate the hydrologic significance of IMERG.

  19. The economics of health information technology in medication management: a systematic review of economic evaluations.

    Science.gov (United States)

    O'Reilly, Daria; Tarride, Jean-Eric; Goeree, Ron; Lokker, Cynthia; McKibbon, K Ann

    2012-01-01

    To conduct a systematic review and synthesis of the evidence surrounding the cost-effectiveness of health information technology (HIT) in the medication process. Peer-reviewed electronic databases and gray literature were searched to identify studies on HIT used to assist in the medication management process. Articles including an economic component were reviewed for further screening. For this review, full cost-effectiveness analyses, cost-utility analyses and cost-benefit analyses, as well as cost analyses, were eligible for inclusion and synthesis. The 31 studies included were heterogeneous with respect to the HIT evaluated, setting, and economic methods used. Thus the data could not be synthesized, and a narrative review was conducted. Most studies evaluated computer decision support systems in hospital settings in the USA, and only five of the studied performed full economic evaluations. Most studies merely provided cost data; however, useful economic data involves far more input. A full economic evaluation includes a full enumeration of the costs, synthesized with the outcomes of the intervention. The quality of the economic literature in this area is poor. A few studies found that HIT may offer cost advantages despite their increased acquisition costs. However, given the uncertainty that surrounds the costs and outcomes data, and limited study designs, it is difficult to reach any definitive conclusion as to whether the additional costs and benefits represent value for money. Sophisticated concurrent prospective economic evaluations need to be conducted to address whether HIT interventions in the medication management process are cost-effective.

  20. Methods of evaluation of smell in victims of subarachnoid hemorrhage patients: a systematic review.

    Science.gov (United States)

    Lima, Sandro Júnior Henrique; Azevedo Filho, Hildo Rocha Cirne de; Silva, Hilton Justino da

    2016-01-01

    To systematically review the methods for evaluation of smell in aneurysmal subarachnoid hemorrhage victims and to identify the changes found with the use of these methods. The literature search was performed in PubMed search platform and in the databases Web of Science, Scopus, PsycINFO, CINAHL, and ScienceDirect in August and September 2014. Original articles published in any language, which addressed smell changes in aneurysmal subarachnoid hemorrhage and addressed to evaluate this function through specific methods were included. Review studies, case studies, book chapters, editorial, and studies that address the nonaneurysmal subarachnoid hemorrhage were excluded. The following variables were considered in data analysis: author/year, country, sample/age, treatment, method, the moment of smell evaluation, and results. The search for articles resulted in 1,763 articles, of which, 9 original articles were selected for this review. It was observed that all articles were from European and Asian countries. Standardized and nonstandardized tests and questionnaires were used in olfactory assessment, and the goals ranged from assessing the smell before and/or after surgery in this population. Heterogeneity was observed in the methods used to evaluate the smell in aneurysmal subarachnoid hemorrhage and in the methods selected for application of evaluations. In addition, studies have demonstrated the existence of olfactory deficits in patients and the relationship between surgery and olfactory dysfunction.

  1. Systematic Review of Health Economic Evaluation Studies Developed in Brazil from 1980 to 2013

    Directory of Open Access Journals (Sweden)

    Tassia Cristina Decimoni

    2018-02-01

    Full Text Available BackgroundBrazil has sought to use economic evaluation to support healthcare decision-making processes. While a number of health economic evaluations (HEEs have been conducted, no study has systematically reviewed the quality of Brazilian HEE. The objective of this systematic review was to provide an overview regarding the state of HEE research and to evaluate the number, characteristics, and quality of reporting of published HEE studies conducted in a Brazilian setting.MethodsWe systematically searched electronic databases (MEDLINE, EMBASE, Latin American, and Caribbean Literature on Health Sciences Database, Scientific Electronic Library Online, NHS Economic Evaluation Database, health technology assessment Database, Bireme, and Biblioteca Virtual em Saúde Economia da Saúde; citation indexes (SCOPUS, Web of Science, and Sistema de Informação da Rede Brasileira de Avaliação de Tecnologia em Saúde. Partial and full HEEs published between 1980 and 2013 that referred to a Brazilian setting were considered for inclusion.ResultsIn total, 535 studies were included in the review, 36.8% of these were considered to be full HEE. The category of healthcare technologies more frequently assessed were procedures (34.8% and drugs (28.8% which main objective was treatment (72.1%. Forty-four percent of the studies reported their funding source and 36% reported a conflict of interest. Overall, the full HEE quality of reporting was satisfactory. But some items were generally poorly reported and significant improvement is required: (1 methods used to estimate healthcare resource use quantities and unit costs, (2 methods used to estimate utility values, (3 sources of funding, and (4 conflicts of interest.ConclusionA steady number of HEE have been published in Brazil since 1980. To improve their contribution to inform national healthcare policy efforts need to be made to enhance the quality of reporting of HEEs and promote improvements in the way HEEs are

  2. Isokinetic Evaluation of the Hip Flexor and Extensor Muscles: A Systematic Review.

    Science.gov (United States)

    Zapparoli, Fabricio Yuri; Riberto, Marcelo

    2016-12-19

    Isokinetic dynamometry testing is a safe and reliable method accepted as the "gold standard" in the evaluation of muscle strength in the open kinetic chain. Isokinetic hip examinations face problems in the standardization of the position of the equipment axis; in the individual being examined; in the adjustment of the lever arm and in stabilization strategies for the patients during the tests. Identification of the methodologic procedures with best reproducibility is also needed. The objective of this study was to review the literature to evaluate the parameters used for the isokinetic evaluation of the hip flexor and extensor muscles and its reproducibility. This is a systematic literature review of the Cochrane, LILACS, PEDro, PubMed, and SciELO databases. The inclusion criteria were papers on the evaluation of hip flexor and/or extensor muscular strength with an isokinetic dynamometer and papers that analyzed the ICC or Pearson's reproducibility. The information extracted was: positioning of the patient; positioning of the dynamometer axis; positioning of the lever arm; angular speed; sample size, pathology; type of contraction and ICC and Pearson's results. On the databases 204 papers were found, from which 14 were selected that evaluated hip flexor and extensor muscles, involving 550 individuals who were submitted to an isokinetic hip evaluation. Five papers obtained the best result in reproducibility and had their methodology analyzed. In order to obtain better reproducibility of the isokinetic evaluation of the hip flexor and extensor muscles, the following recommendations must be followed: the individual must be positioned in the supine position and the dynamometer axis must be aligned with the greater trochanter of the femur. The positioning of the lever arm must be in the most distal region of the thigh possible. The angular speed used to analyze torque peak and muscle work was 60°/s, and to evaluate the muscle power it was 180°/s, with concentric and

  3. A systematic review of economic evaluations of population-based sodium reduction interventions

    Science.gov (United States)

    Hope, Silvia F.; Webster, Jacqui; Trieu, Kathy; Pillay, Arti; Ieremia, Merina; Bell, Colin; Snowdon, Wendy; Neal, Bruce; Moodie, Marj

    2017-01-01

    Objective To summarise evidence describing the cost-effectiveness of population-based interventions targeting sodium reduction. Methods A systematic search of published and grey literature databases and websites was conducted using specified key words. Characteristics of identified economic evaluations were recorded, and included studies were appraised for reporting quality using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results Twenty studies met the study inclusion criteria and received a full paper review. Fourteen studies were identified as full economic evaluations in that they included both costs and benefits associated with an intervention measured against a comparator. Most studies were modelling exercises based on scenarios for achieving salt reduction and assumed effects on health outcomes. All 14 studies concluded that their specified intervention(s) targeting reductions in population sodium consumption were cost-effective, and in the majority of cases, were cost saving. Just over half the studies (8/14) were assessed as being of ‘excellent’ reporting quality, five studies fell into the ‘very good’ quality category and one into the ‘good’ category. All of the identified evaluations were based on modelling, whereby inputs for all the key parameters including the effect size were either drawn from published datasets, existing literature or based on expert advice. Conclusion Despite a clear increase in evaluations of salt reduction programs in recent years, this review identified relatively few economic evaluations of population salt reduction interventions. None of the studies were based on actual implementation of intervention(s) and the associated collection of new empirical data. The studies universally showed that population-based salt reduction strategies are likely to be cost effective or cost saving. However, given the reliance on modelling, there is a need for the effectiveness of new

  4. A systematic review of economic evaluations of population-based sodium reduction interventions.

    Science.gov (United States)

    Hope, Silvia F; Webster, Jacqui; Trieu, Kathy; Pillay, Arti; Ieremia, Merina; Bell, Colin; Snowdon, Wendy; Neal, Bruce; Moodie, Marj

    2017-01-01

    To summarise evidence describing the cost-effectiveness of population-based interventions targeting sodium reduction. A systematic search of published and grey literature databases and websites was conducted using specified key words. Characteristics of identified economic evaluations were recorded, and included studies were appraised for reporting quality using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Twenty studies met the study inclusion criteria and received a full paper review. Fourteen studies were identified as full economic evaluations in that they included both costs and benefits associated with an intervention measured against a comparator. Most studies were modelling exercises based on scenarios for achieving salt reduction and assumed effects on health outcomes. All 14 studies concluded that their specified intervention(s) targeting reductions in population sodium consumption were cost-effective, and in the majority of cases, were cost saving. Just over half the studies (8/14) were assessed as being of 'excellent' reporting quality, five studies fell into the 'very good' quality category and one into the 'good' category. All of the identified evaluations were based on modelling, whereby inputs for all the key parameters including the effect size were either drawn from published datasets, existing literature or based on expert advice. Despite a clear increase in evaluations of salt reduction programs in recent years, this review identified relatively few economic evaluations of population salt reduction interventions. None of the studies were based on actual implementation of intervention(s) and the associated collection of new empirical data. The studies universally showed that population-based salt reduction strategies are likely to be cost effective or cost saving. However, given the reliance on modelling, there is a need for the effectiveness of new interventions to be evaluated in the field using strong

  5. Usability Evaluation Methods for Gesture-Based Games: A Systematic Review.

    Science.gov (United States)

    Simor, Fernando Winckler; Brum, Manoela Rogofski; Schmidt, Jaison Dairon Ebertz; Rieder, Rafael; De Marchi, Ana Carolina Bertoletti

    2016-10-04

    Gestural interaction systems are increasingly being used, mainly in games, expanding the idea of entertainment and providing experiences with the purpose of promoting better physical and/or mental health. Therefore, it is necessary to establish mechanisms for evaluating the usability of these interfaces, which make gestures the basis of interaction, to achieve a balance between functionality and ease of use. This study aims to present the results of a systematic review focused on usability evaluation methods for gesture-based games, considering devices with motion-sensing capability. We considered the usability methods used, the common interface issues, and the strategies adopted to build good gesture-based games. The research was centered on four electronic databases: IEEE, Association for Computing Machinery (ACM), Springer, and Science Direct from September 4 to 21, 2015. Within 1427 studies evaluated, 10 matched the eligibility criteria. As a requirement, we considered studies about gesture-based games, Kinect and/or Wii as devices, and the use of a usability method to evaluate the user interface. In the 10 studies found, there was no standardization in the methods because they considered diverse analysis variables. Heterogeneously, authors used different instruments to evaluate gesture-based interfaces and no default approach was proposed. Questionnaires were the most used instruments (70%, 7/10), followed by interviews (30%, 3/10), and observation and video recording (20%, 2/10). Moreover, 60% (6/10) of the studies used gesture-based serious games to evaluate the performance of elderly participants in rehabilitation tasks. This highlights the need for creating an evaluation protocol for older adults to provide a user-friendly interface according to the user's age and limitations. Through this study, we conclude this field is in need of a usability evaluation method for serious games, especially games for older adults, and that the definition of a methodology

  6. A systematic review of economic evaluations of CHW interventions aimed at improving child health outcomes.

    Science.gov (United States)

    Nkonki, L; Tugendhaft, A; Hofman, K

    2017-02-28

    Evidence of the cost-effectiveness of community health worker interventions is pertinent for decision-makers and programme planners who are turning to community services in order to strengthen health systems in the context of the momentum generated by strategies to support universal health care, the post-2015 Sustainable Development Goal agenda.We conducted a systematic review of published economic evaluation studies of community health worker interventions aimed at improving child health outcomes. Four public health and economic evaluation databases were searched for studies that met the inclusion criteria: National Health Service Economic Evaluation Database (NHS EED), Cochrane, Paediatric Economic Evaluation Database (PEED), and PubMed. The search strategy was tailored to each database.The 19 studies that met the inclusion criteria were conducted in either high income countries (HIC), low- income countries (LIC) and/or middle-income countries (MIC). The economic evaluations covered a wide range of interventions. Studies were grouped together by intended outcome or objective of each study. The data varied in quality. We found evidence of cost-effectiveness of community health worker (CHW) interventions in reducing malaria and asthma, decreasing mortality of neonates and children, improving maternal health, increasing exclusive breastfeeding and improving malnutrition, and positively impacting physical health and psychomotor development amongst children.Studies measured varied outcomes, due to the heterogeneous nature of studies included; a meta-analysis was not conducted. Outcomes included disease- or condition -specific outcomes, morbidity, mortality, and generic measures (e.g. disability-adjusted life years (DALYs)). Nonetheless, all 19 interventions were found to be either cost-effective or highly cost-effective at a threshold specific to their respective countries.There is a growing body of economic evaluation literature on cost-effectiveness of CHW

  7. Evaluation of Anxiety and Depression Among Female Spouses of Iranian Male Drug Dependents

    Science.gov (United States)

    Noori, Roya; Jafari, Firoozeh; Moazen, Babak; Khoddami Vishteh, Hamid Reza; Farhoudian, Ali; Narenjiha, Hooman; Rafiey, Hassan

    2015-01-01

    Background: Existing evidences suggest the more vulnerability of spouses of drug dependents, in exposure to mental disorders. Objectives: This study aimed to evaluate the associated parameters of anxiety and depression among female spouses of male drug dependents. Patients and Methods: With a cross-sectional design in 2010, a total of 237 Iranian women were selected and divided into three groups: 1. non-drug-dependent wives who had non-drug-dependent husbands (Group I), 2. non-drug-dependent wives who had drug-dependent husbands (Group II), and 3. drug-dependent wives who had drug-dependent husbands (Group III). Socio-demographic characteristics were collected by a checklist, and the levels of anxiety and depression were measured through the Hospital Anxiety and Depression Scale (HADS). Linear regression was applied for determination of anxiety and depression predictors. Results: Mean age of the participants was about 35 years, and mean duration of marriage was 14 years. Drug dependence of the husband (P = 0.010) and lower monthly income of the family (P = 0.007) predicted the higher level of anxiety among the participants, while older age (P = 0.031), shorter marital duration (P = 0.016), and lower educational level (P = 0.045) in addition to spousal drug dependence (P = 0.023), and lower family income (P = 0.014) were significantly associated with higher levels of depression. Conclusions: Findings of the present study demonstrate that spousal drug dependence and lower monthly income were common predictors of anxiety and depression among spouses of drug dependents in Iran, while older age, shorter marital duration and lower educational level were predictors of depression. However, more research is needed to find casual relationships between spousal drug dependence and mental health in Iran. PMID:25861583

  8. A systematic evaluation of the core communication skills expected of a perfusionist.

    Science.gov (United States)

    Melchior, R W; Rosenthal, T; Schiavo, K; Frey, T; Rogers, D; Patel, J; Holt, D W

    2012-01-01

    The objective of this systematic evaluation was to identify the sentinel standards necessary to obtain a core level of communication required of a clinical perfusionist during cardiopulmonary bypass (CPB). Once these sentinel standards were identified and a core level of communication was established (via four simulated case scenarios), a team of cardiac healthcare professionals was assembled to interpret both the accuracy of response and the speed of response encountered in each case scenario. Four simulated case scenarios were utilized in order to replicate the typical patterns of verbal exchange that occur during surgeries using extracorporeal technology. The simulated case scenarios included CPB interactions associated with preparation, initiation, maintenance, termination and post CPB. For all CPB interactions, two variables were measured: accuracy of the perfusionist's response and speed of the perfusionist's response. The cases took place in a controlled setting within an empty operating room at The Children's Hospital of Philadelphia. Four clinical perfusionists each represented the role of the "perfusionist" in all simulated case scenarios. When analyzing the accuracy and speed of the responses, each clinical perfusionist recorded an average score of 96.3% or higher with all case scenarios. Since the clinical perfusionists who participated in the scenarios were primarily pediatric perfusionists, the scores were best during the pediatric case scenario, 99.3% (Case Scenario #4). The lowest scores were captured during Case Scenario #3 (96.3%) which involved a more intense adult patient scenario. The systematic evaluation of both response accuracy and response time (presented in various adult and pediatric patient case scenarios) can be beneficial within the realm of perfusion education. Students will be introduced to core communication concepts within the clinical realm. This study supports the idea that simulation and evaluation may ease the transition for

  9. Toward simultaneous PET/MR breast imaging: systematic evaluation and integration of a radiofrequency breast coil.

    Science.gov (United States)

    Aklan, Bassim; Paulus, Daniel H; Wenkel, Evelyn; Braun, Harald; Navalpakkam, Bharath K; Ziegler, Susanne; Geppert, Christian; Sigmund, Eric E; Melsaether, Amy; Quick, Harald H

    2013-02-01

    With the recent introduction of integrated whole-body hybrid positron emission tomography/magnetic resonance (PET/MR) scanners, simultaneous PET/MR breast imaging appears to be a potentially attractive new clinical application. In this study, the technical groundwork toward performing simultaneous PET/MR breast imaging was developed and systematically evaluated in phantom experiments and breast cancer patient hybrid imaging. Measurements were performed on a state-of-the-art whole-body simultaneous PET/MR system (Biograph mMR, Siemens AG, Erlangen, Germany). The PET signal attenuating effects of a MR-only four-channel radiofrequency (RF) breast coil that is present in the PET field-of-view (FoV) during a simultaneous PET/MR data acquisition has been investigated and quantified. For this purpose, a dedicated PET/MR visible breast phantom featuring four modular inserts with various structures (no insert, MR insert, PET insert, and PET/MR insert) was developed. In addition to a systematic evaluation of MR-only image quality, the following phantom scans were performed using (18)F radio tracer: (1) PET emission scan with only the homogeneous breast phantom; (2) PET emission scan additionally with the RF breast coil in the PET FoV. Attenuation correction (AC) of PET data was performed with CT-based three-dimensional (3D) hardware attenuation maps (μ-maps) of the RF coil and breast phantom. Finally, a simultaneous PET/MR breast imaging was performed in two breast cancer patients. The modular breast phantom allowed for systematic evaluation of various MR, PET, and PET/MR image quality parameters. The RF breast coil provided MR images of good image quality, unaffected by PET imaging. The global attenuation of the RF breast coil on the PET emission data was approximately 11%. This hardware attributed PET signal attenuation was successfully corrected by using an appropriate CT-based 3D μ-map of the RF breast coil. Imaging of two breast cancer patients confirmed the

  10. A Systematic Review of Health Economic Evaluation Studies Using the Patient's Perspective.

    Science.gov (United States)

    Tai, Bik-Wai Bilvick; Bae, Yuna H; Le, Quang A

    Patient-centered care has become increasingly important and relevant for informed health care decision making. Our study aimed to perform a systematic review of health economic evaluation studies from the patient's perspective. PubMed, EMBASE, and Cochrane Central databases were searched through May 2014 for cost-effectiveness, cost-utility, and cost-benefit studies using the patient's perspective in their analysis. The reporting quality of the studies was evaluated on the basis of Consolidated Health Economic Evaluation Reporting Standards. We identified 30 health economic evaluations using the patient's perspective, of which 7 were conducted in the United States, 9 in Europe, and 14 in Asian or other countries. Seventeen of 23 health conditions evaluated were chronic in nature. Among 12 studies that justified the use of the patient's perspective, patient's financial burden associated with medical treatment was the most commonly cited rationale. A total of 29, 17, and 15 studies examined direct medical, direct nonmedical, and indirect costs, respectively. Seventeen studies also included societal, governmental or payer's, and/or provider's perspective(s) in their analyses. Based on Consolidated Health Economic Evaluation Reporting Standards, more than 20% of the reporting items in these studies were either partially satisfied or not satisfied. There is a paucity of health economic evaluations conducted from the patient's perspective in the literature. For those studies using the patient's perspective, the true patient costs were not fully explored and study reporting quality was not optimal. With the increasing focus on patient-centered outcomes in health policy research, more frequent use of the patient's perspective in economic studies should be advocated. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. Evaluation Methods for Assessing Users' Psychological Experiences of Web-Based Psychosocial Interventions: A Systematic Review.

    Science.gov (United States)

    Feather, Jacqueline Susan; Howson, Moira; Ritchie, Linda; Carter, Philip D; Parry, David Tudor; Koziol-McLain, Jane

    2016-06-30

    The use of Web-based interventions to deliver mental health and behavior change programs is increasingly popular. They are cost-effective, accessible, and generally effective. Often these interventions concern psychologically sensitive and challenging issues, such as depression or anxiety. The process by which a person receives and experiences therapy is important to understanding therapeutic process and outcomes. While the experience of the patient or client in traditional face-to-face therapy has been evaluated in a number of ways, there appeared to be a gap in the evaluation of patient experiences of therapeutic interventions delivered online. Evaluation of Web-based artifacts has focused either on evaluation of experience from a computer Web-design perspective through usability testing or on evaluation of treatment effectiveness. Neither of these methods focuses on the psychological experience of the person while engaged in the therapeutic process. This study aimed to investigate what methods, if any, have been used to evaluate the in situ psychological experience of users of Web-based self-help psychosocial interventions. A systematic literature review was undertaken of interdisciplinary databases with a focus on health and computer sciences. Studies that met a predetermined search protocol were included. Among 21 studies identified that examined psychological experience of the user, only 1 study collected user experience in situ. The most common method of understanding users' experience was through semistructured interviews conducted posttreatment or questionnaires administrated at the end of an intervention session. The questionnaires were usually based on standardized tools used to assess user experience with traditional face-to-face treatment. There is a lack of methods specified in the literature to evaluate the interface between Web-based mental health or behavior change artifacts and users. Main limitations in the research were the nascency of the topic

  12. The Role of Information Provision in Economic Evaluations of Newborn Bloodspot Screening: A Systematic Review.

    Science.gov (United States)

    Wright, Stuart J; Jones, Cheryl; Payne, Katherine; Dharni, Nimarta; Ulph, Fiona

    2015-12-01

    The extent to which economic evaluations have included the healthcare resource and outcome-related implications of information provision in national newborn bloodspot screening programmes (NBSPs) is not currently known. To identify if, and how, information provision has been incorporated into published economic evaluations of NBSPs. A systematic review of economic evaluations of NBSPs (up to November 2014) was conducted. Three electronic databases were searched (Ovid: Medline, Embase, CINAHL) using an electronic search strategy combining a published economic search filter with terms related to national NBSPs and screening-related technologies. These electronic searches were supplemented by searching the NHS Economic Evaluations Database (NHS EED) and hand-searching identified study reference lists. The results were tabulated and summarised as part of a narrative synthesis. A total of 27 economic evaluations [screening-related technologies (n = 11) and NBSPs (n = 16)] were identified. The majority of economic evaluations did not quantify the impact of information provision in terms of healthcare costs or outcomes. Five studies did include an estimate of the time cost associated with information provision. Four studies included a value to reflect the disutility associated with parental anxiety caused by false-positive results, which was used as a proxy for the impact of imperfect information. A limited evidence base currently quantifies the impact of information provision on the healthcare costs and impact on the users of NBSPs; the parents of newborns. We suggest that economic evaluations of expanded NBSPs need to take account of information provision otherwise the impact on healthcare costs and the outcomes for newborns and their parents may be underestimated.

  13. Systematic review of the quality of economic evaluations in the otolaryngology literature.

    Science.gov (United States)

    Liu, C Carrie; Lui, Justin; Oddone Paolucci, Elizabeth; Rudmik, Luke

    2015-01-01

    To evaluate the quality of economic evaluations published in the otolaryngology--head and neck surgery literature, which will identify methodologic weaknesses that can be improved on in future studies. A secondary objective is to identify factors that may be associated with higher quality economic evaluations. Ovid Medline (including PubMed), Embase, and the National Health Services Economic Evaluation databases. A systematic search was performed of the aforementioned databases according to PRISMA guidelines. The search was performed using otolaryngology key terms combined with the term cost. A manual search of 36 otolaryngology journals was also performed. Included studies were graded using the Quality of Health Economics Studies instrument, a 16-item checklist providing a total quality score of 100. Fifty studies were identified, and the mean quality rating was 54.7/100 (SD = 30.9). The most commonly omitted methodology components were a lack of discussion of limitations and biases, failure to address the negative outcomes of examined interventions, and a lack of a robust sensitivity analysis. Higher quality economic evaluations were associated with a higher journal impact factor (correlation coefficient r = 0.62, P = .0001), having an author with a PhD in health economics (r = 0.56, P = .0001), and having authors who have published prior economic evaluations (r = 0.46, P = .001). Results from this study have demonstrated that there are several methodological domains that can be improved on when publishing economic evaluations in the otolaryngology literature. Authors should follow recommended methodological and reporting guidelines to optimize the transparency and accuracy of the overall conclusions. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  14. Economic evaluations conducted for assessment of genetic testing technologies: a systematic review.

    Science.gov (United States)

    Assasi, Nazila; Schwartz, Lisa; Tarride, Jean-Eric; Goeree, Ron; Xie, Feng

    2012-11-01

    To systematically review the methods used in economic evaluations (EEs) included in health technology assessments (HTAs) of genetic testing technologies (GTTs). A systematic search using bibliographic databases and gray literature was undertaken to identify HTA reports on GTTs that included EEs in addition to clinical effectiveness results. Studies were reviewed in terms of methodology and reporting. Of 361 identified citations, 15 HTAs consisting of 11 model-based and 4 trial-based EEs were included, more than 50% of which had moderate-to-low-quality scores mainly due to not reporting information on basic elements of a standard EE and inadequate management of uncertainty. Cost-effectiveness analysis accounted for 62% of studies. Approximately 66% of the studies adopted a third-party payer perspective, and 46% used a lifelong time horizon. The majority of studies exclusively included technical costs of testing (100%) and therapeutic or preventive interventions (60%). The most frequent variables tested in sensitivity analysis included costs (66%), effects (50%), and transition probabilities (58%). We found several methodological challenges in the reviewed EEs, including identification of a proper analytical perspective, inclusion of wider range of outcomes and costs, allowing for long-term medical and nonmedical impacts of genetic tests, and sufficient management of uncertainty. These issues should be carefully considered in future EEs of GTTs.

  15. Evaluation of the Role of Enteral Nutrition in Managing Patients with Diabetes: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Omorogieva Ojo

    2014-11-01

    Full Text Available The aim of this systematic review is to evaluate the role of enteral nutrition in managing patients with diabetes on enteral feed. The prevalence of diabetes is on the increase in the UK and globally partly due to lack of physical activities, poor dietary regimes and genetic susceptibility. The development of diabetes often leads to complications such as stroke, which may require enteral nutritional support. The provision of enteral feeds comes with its complications including hyperglycaemia which if not managed can have profound consequences for the patients in terms of clinical outcomes. Therefore, it is essential to develop strategies for managing patients with diabetes on enteral feed with respect to the type and composition of the feed. This is a systematic review of published peer reviewed articles. EBSCOhost Research, PubMed and SwetsWise databases were searched. Reference lists of identified articles were reviewed. Randomised controlled trials comparing enteral nutrition diabetes specific formulas with standard formulas were included. The studies which compared diabetes specific formulas (DSF with standard formulas showed that DSF was more effective in controlling glucose profiles including postprandial glucose, HbA1c and insulinemic response. The use of DSF appears to be effective in managing patients with diabetes on enteral feed compared with standard feed.

  16. Development of an integrated surface stimulation device for systematic evaluation of wound electrotherapy.

    Science.gov (United States)

    Howe, D S; Dunning, J; Zorman, C; Garverick, S L; Bogie, K M

    2015-02-01

    Ideally, all chronic wounds would be prevented as they can become life threatening complications. The concept that a wound produces a 'current of injury' due to the discontinuity in the electrical field of intact skin provides the basis for the concept that electrical stimulation (ES) may provide an effective treatment for chronic wounds. The optimal stimulation waveform parameters are unknown, limiting the reliability of achieving a successful clinical therapeutic outcome. In order to gain a more thorough understanding of ES for chronic wound therapy, systematic evaluation using a valid in vivo model is required. The focus of the current paper is development of the flexible modular surface stimulation (MSS) device by our group. This device can be programed to deliver a variety of clinically relevant stimulation paradigms and is essential to facilitate systematic in vivo studies. The MSS version 2.0 for small animal use provides all components of a single-channel, programmable current-controlled ES system within a lightweight, flexible, independently-powered portable device. Benchtop testing and validation indicates that custom electronics and control algorithms support the generation of high-voltage, low duty-cycle current pulses in a power-efficient manner, extending battery life and allowing ES therapy to be delivered for up to 7 days without needing to replace or disturb the wound dressing.

  17. Economic evaluation of HBV vaccination: A systematic review of recent publications (2000-2013).

    Science.gov (United States)

    La Torre, Giuseppe; Mannocci, Alice; Saulle, Rosella; Colamesta, Vittoria; Meggiolaro, Angela; Mipatrini, Daniele; Sinopoli, Alessandra

    2016-09-01

    To conduct a systematic review of the economic evaluations (EE) of HBV vaccination, taking also into account the studies published in the new millennium. An extensive scientific literature review was conducted using two electronic medical journal databases: Scopus and PubMed engines for published studies on EE of HBV vaccination. 22 articles were reviewed, 9, 5 and 8 cost-effectiveness, cost-benefit and cost-utility analysis, respectively. Studies were mainly concerning EE of universal vaccination (UV), mostly with regards to low or low-medium income countries. For high income countries, EE were focused on the possible implementation of HBV vaccination in particular settings, such as diabetic, renal and other chronic conditions care, as well as infectious diseasesUV has usually a very good cost-effectiveness ratio (80%), ranging from cost-saving (China) or few Euro per LY/QALY gained (in Thailand, and Vietnam) to 630.00$/QALY in USA (Asian and Pacific Islands) Moreover, EE of HBV vaccination are favorable in the infectious diseases field as well as for chronic conditions. In relation to diabetes the studies gave controversial results. This systematic review highlighted the importance of introducing HBV vaccination not only for infant UV program but also for other settings in which patients are people affected by communicable and non-communicable diseases.

  18. Economic evaluation in chronic pain: a systematic review and de novo flexible economic model.

    Science.gov (United States)

    Sullivan, W; Hirst, M; Beard, S; Gladwell, D; Fagnani, F; López Bastida, J; Phillips, C; Dunlop, W C N

    2016-07-01

    There is unmet need in patients suffering from chronic pain, yet innovation may be impeded by the difficulty of justifying economic value in a field beset by data limitations and methodological variability. A systematic review was conducted to identify and summarise the key areas of variability and limitations in modelling approaches in the economic evaluation of treatments for chronic pain. The results of the literature review were then used to support the development of a fully flexible open-source economic model structure, designed to test structural and data assumptions and act as a reference for future modelling practice. The key model design themes identified from the systematic review included: time horizon; titration and stabilisation; number of treatment lines; choice/ordering of treatment; and the impact of parameter uncertainty (given reliance on expert opinion). Exploratory analyses using the model to compare a hypothetical novel therapy versus morphine as first-line treatments showed cost-effectiveness results to be sensitive to structural and data assumptions. Assumptions about the treatment pathway and choice of time horizon were key model drivers. Our results suggest structural model design and data assumptions may have driven previous cost-effectiveness results and ultimately decisions based on economic value. We therefore conclude that it is vital that future economic models in chronic pain are designed to be fully transparent and hope our open-source code is useful in order to aspire to a common approach to modelling pain that includes robust sensitivity analyses to test structural and parameter uncertainty.

  19. Predonation psychosocial evaluation of living kidney and liver donor candidates: a systematic literature review.

    Science.gov (United States)

    Duerinckx, Nathalie; Timmerman, Lotte; Van Gogh, Johan; van Busschbach, Jan; Ismail, Sohal Y; Massey, Emma K; Dobbels, Fabienne

    2014-01-01

    Evaluating a person's suitability for living organ donation is crucial, consisting not only of a medical but also of a thorough psychosocial screening. We performed a systematic literature review of guidelines, consensus statements, and protocols on the content and process of psychosocial screening of living kidney and liver donor candidates. We searched PubMed, Embase, CINAHL, and PsycINFO until June 22, 2011, following the PRISMA guidelines, complemented by scrutinizing guidelines databases and references of identified publications. Thirty-four publications were identified, including seven guidelines, six consensus statements, and 21 protocols or programs. Guidelines and consensus statements were inconsistent and lacked concreteness for both their content and process, possibly explaining the observed variability in center-specific evaluation protocols and programs. Overall, recommended screening criteria are not evidence-based and an operational definition of the concept "psychosocial" is missing, causing heterogeneity in terminology. Variation also exists on methods used to psychosocially evaluate potential donors. The scientific basis of predonation psychosocial evaluation needs to be strengthened. There is a need for high-quality prospective psychosocial outcome studies in living donors, a uniform terminology to label psychosocial screening criteria, and validated instruments to identify risk factors. © 2013 Steunstichting ESOT. Published by John Wiley & Sons Ltd.

  20. Low health literacy and evaluation of online health information: a systematic review of the literature.

    Science.gov (United States)

    Diviani, Nicola; van den Putte, Bas; Giani, Stefano; van Weert, Julia Cm

    2015-05-07

    Recent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to design high-quality online health information. However, little attention has been devoted to how consumers, in particular people with low health literacy, evaluate online health information. The main aim of this study was to review existing evidence on the association between low health literacy and (1) people's ability to evaluate online health information, (2) perceived quality of online health information, (3) trust in online health information, and (4) use of evaluation criteria for online health information. Five academic databases (MEDLINE, PsycINFO, Web of Science, CINAHL, and Communication and Mass-media Complete) were systematically searched. We included peer-reviewed publications investigating differences in the evaluation of online information between people with different health literacy levels. After abstract and full-text screening, 38 articles were included in the review. Only four studies investigated the specific role of low health literacy in the evaluation of online health information. The other studies examined the association between educational level or other skills-based proxies for health literacy, such as general literacy, and outcomes. Results indicate that low health literacy (and related skills) are negatively related to the ability to evaluate online health information and trust in online health information. Evidence on the association with perceived quality of online health information and use of evaluation criteria is inconclusive. The findings indicate that low health literacy (and related skills) play a role in the evaluation of online health information. This topic is therefore worth more scholarly attention. Based on the results of this review

  1. Low Health Literacy and Evaluation of Online Health Information: A Systematic Review of the Literature

    Science.gov (United States)

    van den Putte, Bas; Giani, Stefano; van Weert, Julia CM

    2015-01-01

    Background Recent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to design high-quality online health information. However, little attention has been devoted to how consumers, in particular people with low health literacy, evaluate online health information. Objective The main aim of this study was to review existing evidence on the association between low health literacy and (1) people’s ability to evaluate online health information, (2) perceived quality of online health information, (3) trust in online health information, and (4) use of evaluation criteria for online health information. Methods Five academic databases (MEDLINE, PsycINFO, Web of Science, CINAHL, and Communication and Mass-media Complete) were systematically searched. We included peer-reviewed publications investigating differences in the evaluation of online information between people with different health literacy levels. Results After abstract and full-text screening, 38 articles were included in the review. Only four studies investigated the specific role of low health literacy in the evaluation of online health information. The other studies examined the association between educational level or other skills-based proxies for health literacy, such as general literacy, and outcomes. Results indicate that low health literacy (and related skills) are negatively related to the ability to evaluate online health information and trust in online health information. Evidence on the association with perceived quality of online health information and use of evaluation criteria is inconclusive. Conclusions The findings indicate that low health literacy (and related skills) play a role in the evaluation of online health information. This topic is therefore worth more scholarly

  2. Environmental Indicators for the Evaluation of Wood Products in Consideration of Site-Dependent Aspects: A Review and Integrated Approach

    Directory of Open Access Journals (Sweden)

    Nadine May

    2017-10-01

    Full Text Available On the way towards a more biobased economy, the sustainable use of global wood resources remains a challenge as several trade-offs arise, e.g., from an increased energetic use of wood, an increased use of innovative but probably less recyclable wood composites, or from the need to conserve other forest ecosystem services. The aim of this study is to identify existing environmental indicators and methods for an evaluation of the sustainability of wood products in consideration of all life cycle stages, site-dependent aspects and later use in corporate decision-making. We chose a systematic literature review to answer the research questions explicitly and comprehensively. Qualitative content analysis was used to code indicators and scientific methods according to the Pressure-State-Response (PSR framework. The sample (N = 118 is characterized by a high number of life cycle assessment (LCA case studies. In 51% of all studies, the study authors use a combination of different methods. A total of 78 indicators and 20 site-dependent aspects could be identified in the sample. The study findings represent a first step towards a holistic environmental assessment of wood products.

  3. A Systematic Evaluation of Mobile Applications for Instant Messaging on iOS Devices

    Directory of Open Access Journals (Sweden)

    Sergio Caro-Alvaro

    2017-01-01

    Full Text Available Nowadays, instant messaging applications (apps are one of the most popular applications for mobile devices with millions of active users. However, mobile devices present hardware and software characteristics and limitations compared with personal computers. Hence, to address the usability issues of mobile apps, a specific methodology must be conducted. This paper shows the findings from a systematic analysis of these applications on iOS mobile platform that was conducted to identify some usability issues in mobile applications for instant messaging. The overall process includes a Keystroke-Level Modeling and a Mobile Heuristic Evaluation. In the same trend, we propose a set of guidelines for improving the usability of these apps. Based on our findings, this analysis will help in the future to create more effective mobile applications for instant messaging.

  4. A process evaluation of systematic risk and needs assessment for caregivers in specialised palliative care

    DEFF Research Database (Denmark)

    Thomsen, Kia Toft; Guldin, Mai-Britt; Nielsen, Mette Kjærgaard

    2017-01-01

    to caregivers are often unclear in the daily practice. Assessment is recommended to establish risk and needs and standards for caregiver support are available. Still, the feasibility of applying these standards among caregivers in everyday clinical practice has not been tested so far. METHODS: This study tested...... the feasibility of an intervention based on key elements of the "Bereavement support standards for specialist palliative care services" in a Danish specialised palliative home care team. We followed the UK Medical Research Council's guidelines for the process evaluation of complex interventions. The intervention...... consisted of: 1. Systematic risk and needs assessment for caregivers at care entry; 2. Interdisciplinary conference to prepare a support plan; 3. Targeted support; 4. The establishment of an electronic medical record for caregivers to document targeted support. Outcomes included the reach, fidelity...

  5. A systematic review of randomized trials evaluating regional techniques for postthoracotomy analgesia

    DEFF Research Database (Denmark)

    Joshi, G.P.; Bonnet, F.; Shah, R.

    2008-01-01

    of the evidence is needed to assess the comparative benefits of alternative techniques, guide clinical practice and identify areas requiring further research. METHODS: In this systematic review of randomized trials we evaluated thoracic epidural, paravertebral, intrathecal, intercostal, and interpleural analgesic...... techniques, compared to each other and to systemic opioid analgesia, in adult thoracotomy. Postoperative pain, analgesic use, and complications were analyzed. RESULTS: Continuous paravertebral block was as effective as thoracic epidural analgesia with local anesthetic (LA) but was associated with a reduced...... incidence of hypotension. Paravertebral block reduced the incidence of pulmonary complications compared with systemic analgesia, whereas thoracic epidural analgesia did not. Thoracic epidural analgesia was superior to intrathecal and intercostal techniques, although these were superior to systemic analgesia...

  6. Evaluation models and criteria of the quality of hospital websites: a systematic review study.

    Science.gov (United States)

    Jeddi, Fatemeh Rangraz; Gilasi, Hamidreza; Khademi, Sahar

    2017-02-01

    Hospital websites are important tools in establishing communication and exchanging information between patients and staff, and thus should enjoy an acceptable level of quality. The aim of this study was to identify proper models and criteria to evaluate the quality of hospital websites. This research was a systematic review study. The international databases such as Science Direct, Google Scholar, PubMed, Proquest, Ovid, Elsevier, Springer, and EBSCO together with regional database such as Magiran, Scientific Information Database, Persian Journal Citation Report (PJCR) and IranMedex were searched. Suitable keywords including website, evaluation, and quality of website were used. Full text papers related to the research were included. The criteria and sub criteria of the evaluation of website quality were extracted and classified. To evaluate the quality of the websites, various models and criteria were presented. The WEB-Q-IM, Mile, Minerva, Seruni Luci, and Web-Qual models were the designed models. The criteria of accessibility, content and apparent features of the websites, the design procedure, the graphics applied in the website, and the page's attractions have been mentioned in the majority of studies. The criteria of accessibility, content, design method, security, and confidentiality of personal information are the essential criteria in the evaluation of all websites. It is suggested that the ease of use, graphics, attractiveness and other apparent properties of websites are considered as the user-friendliness sub criteria. Further, the criteria of speed and accessibility of the website should be considered as sub criterion of efficiency. When determining the evaluation criteria of the quality of websites, attention to major differences in the specific features of any website is essential.

  7. Evaluating the Psychometric Quality of Social Skills Measures: A Systematic Review.

    Science.gov (United States)

    Cordier, Reinie; Speyer, Renée; Chen, Yu-Wei; Wilkes-Gillan, Sarah; Brown, Ted; Bourke-Taylor, Helen; Doma, Kenji; Leicht, Anthony

    2015-01-01

    Impairments in social functioning are associated with an array of adverse outcomes. Social skills measures are commonly used by health professionals to assess and plan the treatment of social skills difficulties. There is a need to comprehensively evaluate the quality of psychometric properties reported across these measures to guide assessment and treatment planning. To conduct a systematic review of the literature on the psychometric properties of social skills and behaviours measures for both children and adults. A systematic search was performed using four electronic databases: CINAHL, PsycINFO, Embase and Pubmed; the Health and Psychosocial Instruments database; and grey literature using PsycExtra and Google Scholar. The psychometric properties of the social skills measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. Thirty-Six studies and nine manuals were included to assess the psychometric properties of thirteen social skills measures that met the inclusion criteria. Most measures obtained excellent overall methodological quality scores for internal consistency and reliability. However, eight measures did not report measurement error, nine measures did not report cross-cultural validity and eleven measures did not report criterion validity. The overall quality of the psychometric properties of most measures was satisfactory. The SSBS-2, HCSBS and PKBS-2 were the three measures with the most robust evidence of sound psychometric quality in at least seven of the eight psychometric properties that were appraised. A universal working definition of social functioning as an overarching construct is recommended. There is a need for ongoing research in the area of the psychometric properties of social skills and behaviours instruments.

  8. Screening for Chlamydia trachomatis: a systematic review of the economic evaluations and modelling

    Science.gov (United States)

    Roberts, T E; Robinson, S; Barton, P; Bryan, S; Low, N

    2006-01-01

    Objective To review systematically and critically, evidence used to derive estimates of costs and cost effectiveness of chlamydia screening. Methods Systematic review. A search of 11 electronic bibliographic databases from the earliest date available to August 2004 using keywords including chlamydia, pelvic inflammatory disease, economic evaluation, and cost. We included studies of chlamydia screening in males and/or females over 14 years, including studies of diagnostic tests, contact tracing, and treatment as part of a screening programme. Outcomes included cases of chlamydia identified and major outcomes averted. We assessed methodological quality and the modelling approach used. Results Of 713 identified papers we included 57 formal economic evaluations and two cost studies. Most studies found chlamydia screening to be cost effective, partner notification to be an effective adjunct, and testing with nucleic acid amplification tests, and treatment with azithromycin to be cost effective. Methodological problems limited the validity of these findings: most studies used static models that are inappropriate for infectious diseases; restricted outcomes were used as a basis for policy recommendations; and high estimates of the probability of chlamydia associated complications might have overestimated cost effectiveness. Two high quality dynamic modelling studies found opportunistic screening to be cost effective but poor reporting or uncertainty about complication rates make interpretation difficult. Conclusion The inappropriate use of static models to study interventions to prevent a communicable disease means that uncertainty remains about whether chlamydia screening programmes are cost effective or not. The results of this review can be used by health service managers in the allocation of resources, and health economists and other researchers who are considering further research in this area. PMID:16731666

  9. Evaluating the Psychometric Quality of Social Skills Measures: A Systematic Review

    Science.gov (United States)

    Brown, Ted; Bourke-Taylor, Helen; Doma, Kenji; Leicht, Anthony

    2015-01-01

    Introduction Impairments in social functioning are associated with an array of adverse outcomes. Social skills measures are commonly used by health professionals to assess and plan the treatment of social skills difficulties. There is a need to comprehensively evaluate the quality of psychometric properties reported across these measures to guide assessment and treatment planning. Objective To conduct a systematic review of the literature on the psychometric properties of social skills and behaviours measures for both children and adults. Methods A systematic search was performed using four electronic databases: CINAHL, PsycINFO, Embase and Pubmed; the Health and Psychosocial Instruments database; and grey literature using PsycExtra and Google Scholar. The psychometric properties of the social skills measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. Results Thirty-Six studies and nine manuals were included to assess the psychometric properties of thirteen social skills measures that met the inclusion criteria. Most measures obtained excellent overall methodological quality scores for internal consistency and reliability. However, eight measures did not report measurement error, nine measures did not report cross-cultural validity and eleven measures did not report criterion validity. Conclusions The overall quality of the psychometric properties of most measures was satisfactory. The SSBS-2, HCSBS and PKBS-2 were the three measures with the most robust evidence of sound psychometric quality in at least seven of the eight psychometric properties that were appraised. A universal working definition of social functioning as an overarching construct is recommended. There is a need for ongoing research in the area of the psychometric properties of social skills and behaviours instruments. PMID:26151362

  10. Methods for the evaluation of hospital cooperation activities (Systematic review protocol

    Directory of Open Access Journals (Sweden)

    Rotter Thomas

    2012-02-01

    Full Text Available Abstract Background Hospital partnerships, mergers and cooperatives are arrangements frequently seen as a means of improving health service delivery. Many of the assumptions used in planning hospital cooperatives are not stated clearly and are often based on limited or poor scientific evidence. Methods This is a protocol for a systematic review, following the Cochrane EPOC methodology. The review aims to document, catalogue and synthesize the existing literature on the reported methods for the evaluation of hospital cooperation activities as well as methods of hospital cooperation. We will search the Database of Abstracts of Reviews of Effectiveness, the Effective Practice and Organisation of Care Register, the Cochrane Central Register of Controlled Trials and bibliographic databases including PubMed (via NLM, Web of Science, NHS EED, Business Source Premier (via EBSCO and Global Health for publications that report on methods for evaluating hospital cooperatives, strategic partnerships, mergers, alliances, networks and related activities and methods used for such partnerships. The method proposed by the Cochrane EPOC group regarding randomized study designs, controlled clinical trials, controlled before and after studies, and interrupted time series will be followed. In addition, we will also include cohort, case-control studies, and relevant non-comparative publications such as case reports. We will categorize and analyze the review findings according to the study design employed, the study quality (low versus high quality studies and the method reported in the primary studies. We will present the results of studies in tabular form. Discussion Overall, the systematic review aims to identify, assess and synthesize the evidence to underpin hospital cooperation activities as defined in this protocol. As a result, the review will provide an evidence base for partnerships, alliances or other fields of cooperation in a hospital setting. PROSPERO

  11. Temperature dependence of alkali-antimonide photocathodes: Evaluation at cryogenic temperatures

    Science.gov (United States)

    Mamun, M. A.; Hernandez-Flores, M. R.; Morales, E.; Hernandez-Garcia, C.; Poelker, M.

    2017-10-01

    CsxKySb photocathodes were manufactured on a niobium substrate and evaluated over a range of temperatures from 300 to 77 K. Vacuum conditions were identified that minimize surface contamination due to gas adsorption when samples were cooled below room temperature. Measurements of the photocathode spectral response provided a means to evaluate the photocathode band gap dependence on the temperature and to predict the photocathode quantum efficiency at 4 K, a typical temperature at which superconducting radio frequency photoguns operate.

  12. Scientific Evaluation and Review of Claims in Health Care (SEaRCH): A Streamlined, Systematic, Phased Approach for Determining "What Works" in Healthcare.

    Science.gov (United States)

    Jonas, Wayne B; Crawford, Cindy; Hilton, Lara; Elfenbaum, Pamela

    2017-01-01

    Answering the question of "what works" in healthcare can be complex and requires the careful design and sequential application of systematic methodologies. Over the last decade, the Samueli Institute has, along with multiple partners, developed a streamlined, systematic, phased approach to this process called the Scientific Evaluation and Review of Claims in Health Care (SEaRCH™). The SEaRCH process provides an approach for rigorously, efficiently, and transparently making evidence-based decisions about healthcare claims in research and practice with minimal bias. SEaRCH uses three methods combined in a coordinated fashion to help determine what works in healthcare. The first, the Claims Assessment Profile (CAP), seeks to clarify the healthcare claim and question, and its ability to be evaluated in the context of its delivery. The second method, the Rapid Evidence Assessment of the Literature (REAL(©)), is a streamlined, systematic review process conducted to determine the quantity, quality, and strength of evidence and risk/benefit for the treatment. The third method involves the structured use of expert panels (EPs). There are several types of EPs, depending on the purpose and need. Together, these three methods-CAP, REAL, and EP-can be integrated into a strategic approach to help answer the question "what works in healthcare?" and what it means in a comprehensive way. SEaRCH is a systematic, rigorous approach for evaluating healthcare claims of therapies, practices, programs, or products in an efficient and stepwise fashion. It provides an iterative, protocol-driven process that is customized to the intervention, consumer, and context. Multiple communities, including those involved in health service and policy, can benefit from this organized framework, assuring that evidence-based principles determine which healthcare practices with the greatest promise are used for improving the public's health and wellness.

  13. Systematic evaluation of the quality of clinical practice guidelines on the use of assisted reproductive techniques.

    Science.gov (United States)

    Gutarra-Vilchez, Rosa Bertha; Barajas-Nava, Leticia; Aleman, Alicia; Solà, Ivan; Gich, Ignasi; Bonfill, Xavier; Alonso-Coello, Pablo

    2014-03-01

    To conduct a systematic evaluation of clinical practice guidelines (CPGs) on the use of assisted reproductive technologies. We searched Medline, the Turning Research into Practice database, and guidelines-specific databases from December 2006 to November 2011. Three reviewers independently assessed each Guideline using the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument. A standardized score was calculated separately for each of the six domains. Fourteen Guidelines were included. Overall, the quality of these was suboptimal. The scores for each AGREE II domain ranged between 37% and 80%. Three (22%) were deemed "Recommended"; nine (64%),"Recommended with modifications"; and two (14%), "Not recommended". Agreement among reviewers was very good (Intraclass Correlation Coefficient: 0.915 [95% CI 0.807-0.970]). The overall quality of the CPGs on Assisted Reproduction Techniques published during the last 5 years is suboptimal. Most Guidelines present significant shortcomings in important domains such as "stakeholder involvement", "rigor of development", and "applicability". Instruments such as the AGREE II and "the Grading of Recommendation Assessment Development and Evaluation" system could prove useful to improve CPGs in this field. Guideline users could benefit from the present results when choosing which guidelines to implement.

  14. An appraisal of published usability evaluations of electronic health records via systematic review.

    Science.gov (United States)

    Ellsworth, Marc A; Dziadzko, Mikhail; O'Horo, John C; Farrell, Ann M; Zhang, Jiajie; Herasevich, Vitaly

    2017-01-01

    In this systematic review, we aimed to evaluate methodological and reporting trends present in the current literature by investigating published usability studies of electronic health records (EHRs). A literature search was conducted for articles published through January 2015 using MEDLINE (Ovid), EMBASE, Scopus, and Web of Science, supplemented by citation and reference list reviews. Studies were included if they tested the usability of hospital and clinic EHR systems in the inpatient, outpatient, emergency department, or operating room setting. A total of 4848 references were identified for title and abstract screening. Full text screening was performed for 197 articles, with 120 meeting the criteria for study inclusion. A review of the literature demonstrates a paucity of quality published studies describing scientifically valid and reproducible usability evaluations at various stages of EHR system development. A lack of formal and standardized reporting of EHR usability evaluation results is a major contributor to this knowledge gap, and efforts to improve this deficiency will be one step of moving the field of usability engineering forward. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Economic evaluations of diagnostic tests, treatment and prevention for lateral ankle sprains: a systematic review.

    Science.gov (United States)

    Lin, Chung-Wei Christine; Uegaki, Kimi; Coupé, Veerle M H; Kerkhoffs, Gino M; van Tulder, Maurits W

    2013-12-01

    To assess and summarise the economic evidence regarding diagnostic tests, treatment and prevention for lateral ankle sprains. Potential studies were identified from electronic databases and trial registries and by scanning reference lists. Risk of bias and methodological quality were evaluated. Two independent reviewers screened, assessed studies and extracted data. Data were synthesised descriptively due to study heterogeneity. A total of 230 records were identified; 10 studies were included. Five studies conducted a full economic evaluation and five studies involved cost analyses. Lack of blinding was the main risk of bias. The methodological quality of the full economic evaluations was fairly good. Valuation of costs, measurement of outcomes and sensitivity analysis were points for improvement. Single studies showed that the Ottawa ankle rules (OAR) was cost effective for diagnosing lateral ankle sprains in the emergency setting compared with existing hospital protocols; acute treatment with anti-inflammatory medication and the plaster cast for severe sprains appeared cost effective; and neuromuscular training was cost effective in preventing ankle re-injury. Results of this current systematic review supplements the evidence provided by reviews of effectiveness. There is evidence to support the implementation of OAR in the emergency setting, the use of anti-inflammatory medication and the plaster cast in the acute phase, and the prescription of neuromuscular exercises to prevent re-injury. Although the evidence is limited due to the low number of studies, shortcomings in methodological quality and small sample sizes, the findings may be used to inform clinical practice and practice guidelines.

  16. Economic evaluation of interventions for malignant neoplasms in Spain: systematic review and comparative analysis.

    Science.gov (United States)

    Catalá-López, F; García-Altés, A; Álvarez-Martín, E; Gènova-Maleras, R; Morant-Ginestar, C; Arana, E

    2012-01-01

    To review standard methods used to evaluate the efficiency of oncology interventions, comparing their main characteristics with those of the studies aimed for other conditions. We performed a systematic review and comparative analysis calculating odds ratios (OR). We searched the biomedical literature to assess economic evaluation studies on malignant neoplasms in Spain published between 1983 and 2008. Their characteristics were reviewed and summarised, including the following variables: journal and year of publication, intervention, type and design of study, perspective, type of costs, financing source, and decision-making recommendations. Sixty-three studies were included. Main characteristics of the reports were: cost-effectiveness analysis and therapeutic interventions (60.3%; n=38). Seventeen studies (27.0%) used an observational design. Economic evaluations of malignant neoplasms showed the following associations (compared to those studies addressing other causes [n=411]): cost minimisation analysis (OR: 1.73; 95% confidence interval [CI]: 0.91-3.27), diagnostic interventions (OR: 2.18; 95% CI: 1.07-4.43), decision analysis design (OR: 0.46; 95% CI: 0.24-0.87), societal perspective (OR: 0.20; 95% CI: 0.05-0.86) and for-profit source of financing (OR: 0.52; 95% CI: 0.30-0.93). Economic evaluations of interventions for malignant neoplasms are not common despite the gradual increase produced during recent years in Spain. Reports presented heterogeneity in the quality of the information regarding the methods and the data sources used. Further efficiency evaluations of oncology interventions are needed and methodological quality should be warranted. Copyright © 2010 SEFH. Published by Elsevier Espana. All rights reserved.

  17. Evaluation of Wet Cupping Therapy: Systematic Review of Randomized Clinical Trials.

    Science.gov (United States)

    Al Bedah, Abdullah M N; Khalil, Mohamed K M; Posadzki, Paul; Sohaibani, Imen; Aboushanab, Tamer Shaaban; AlQaed, Meshari; Ali, Gazzaffi I M

    2016-10-01

    Wet cupping is a widely used traditional therapy in many countries, which justifies a continuous scientific evaluation of its efficacy and safety. To perform a systematic review to critically evaluate and update the available evidence of wet cupping in traditional and complementary medicine. Ten electronic databases were searched from their inceptions to February 2016. Included studies were randomized clinical trials (RCTs) that evaluated wet cupping against any type of control interventions in patients with any clinical condition, as well as healthy individuals. Cochrane risk of bias tool was used to appraise the included RCTs. Fourteen RCTs met the eligibility criteria. The included studies evaluated the following clinical conditions: nonspecific low back pain (NSLBP), hypertension, brachialgia, carpal tunnel syndrome (CTS), chronic neck pain, metabolic syndrome, migraine headaches, oxygen saturation in smokers with chronic obstructive pulmonary disease (COPD), and oral and genital ulcers due to Behçet disease. Two RCTs evaluated physiologic and biochemical parameters of healthy individuals. Overall, 9 RCTs favored wet cupping over various control interventions in NSLBP (n = 2), hypertension (n = 1), brachialgia (n = 1), CTS (n = 1), chronic neck pain (n = 2), oxygen saturation in smokers with COPD (n = 1), and oral and genital ulcers due to Behçet disease (n = 1). Five RCTs showed no statistically significant between-group differences: NSLBP (n = 1), metabolic syndrome (n = 1), migraine headaches (n = 1), and physiologic and biochemical parameters of healthy individuals (n = 2). Included RCTs had a variable risk of bias across all domains and suffered methodologic limitations. There is a promising evidence in favor of the use of wet cupping for musculoskeletal pain, specifically NSLBP, neck pain, CTS, and brachialgia. Better-quality trials are needed to generate solid evidence and firmly inform policy makers.

  18. Evaluating mobile phone applications for health behaviour change: A systematic review.

    Science.gov (United States)

    McKay, Fiona H; Cheng, Christina; Wright, Annemarie; Shill, Jane; Stephens, Hugh; Uccellini, Mary

    2016-10-18

    Increasing smartphones access has allowed for increasing development and use of smart phone applications (apps). Mobile health interventions have previously relied on voice or text-based short message services (SMS), however, the increasing availability and ease of use of apps has allowed for significant growth of smartphone apps that can be used for health behaviour change. This review considers the current body of knowledge relating to the evaluation of apps for health behaviour change. The aim of this review is to investigate approaches to the evaluation of health apps to identify any current best practice approaches. A systematic review was conducted. Data were collected and analysed in September 2016. Thirty-eight articles were identified and have been included in this review. Articles were published between 2011- 2016, and 36 were reviews or evaluations of apps related to one or more health conditions, the remaining two reported on an investigation of the usability of health apps. Studies investigated apps relating to the following areas: alcohol, asthma, breastfeeding, cancer, depression, diabetes, general health and fitness, headaches, heart disease, HIV, hypertension, iron deficiency/anaemia, low vision, mindfulness, obesity, pain, physical activity, smoking, weight management and women's health. In order to harness the potential of mobile health apps for behaviour change and health, we need better ways to assess the quality and effectiveness of apps. This review is unable to suggest a single best practice approach to evaluate mobile health apps. Few measures identified in this review included sufficient information or evaluation, leading to potentially incomplete and inaccurate information for consumers seeking the best app for their situation. This is further complicated by a lack of regulation in health promotion generally. © The Author(s) 2016.

  19. Neonatal respiratory insufficiency caused by an (homozygous) ABCA3-stop mutation: a systematic evaluation of therapeutic options.

    Science.gov (United States)

    Winter, J; Essmann, S; Kidszun, A; Aslanidis, C; Griese, M; Poplawska, K; Bartsch, M; Schmitz, G; Mildenberger, E

    2014-04-01

    Autosomal recessive ABCA3 (ATP-binding cassette protein A3) gene mutations have been associated with neonatal respiratory distress and pediatric interstitial lung disease. The clinical course of the disease depends on the underlying mutations. Therefore, knowledge of course, symptoms and treatment of the disease is important. A term newborn suffered from progressive respiratory insufficiency, which led to death at the age of 4.8 months. The girl developed interstitial lung disease. Infections as well as structural and functional disorders of the lung were systematically excluded. A homozygous c.4681C > T (Arg 1561 Stop) mutation of the ABCA3 gene was identified. A literature review of the pathophysiology and treatment options of the disease was done. Therapeutic approaches with corticosteroids, macrolide, and hydroxychloroquine did not improve the clinical course. Therapeutic strategies for chronic interstitial lung disease have been used successfully in cases of a mild clinical course in juvenile patients with ABCA3 gene mutation. In our patient with homozygous ABCA3 gene mutation,they were not effective. Lung transplantation remains as a therapeutic option, but because of donor organ shortage and associated morbidity and mortality it is rarely feasible. More experience in the treatment of newborns with ABCA3 gene mutations is needed. Randomized, prospective evaluation of the different therapeutic approaches in a specific registry may improve prognosis and treatment of affected individuals. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Evaluation of two dependency parsers on biomedical corpus targeted at protein-protein interactions.

    Science.gov (United States)

    Pyysalo, Sampo; Ginter, Filip; Pahikkala, Tapio; Boberg, Jorma; Järvinen, Jouni; Salakoski, Tapio

    2006-06-01

    We present an evaluation of Link Grammar and Connexor Machinese Syntax, two major broad-coverage dependency parsers, on a custom hand-annotated corpus consisting of sentences regarding protein-protein interactions. In the evaluation, we apply the notion of an interaction subgraph, which is the subgraph of a dependency graph expressing a protein-protein interaction. We measure the performance of the parsers for recovery of individual dependencies, fully correct parses, and interaction subgraphs. For Link Grammar, an open system that can be inspected in detail, we further perform a comprehensive failure analysis, report specific causes of error, and suggest potential modifications to the grammar. We find that both parsers perform worse on biomedical English than previously reported on general English. While Connexor Machinese Syntax significantly outperforms Link Grammar, the failure analysis suggests specific ways in which the latter could be modified for better performance in the domain.

  1. The effect of dependence on the performance of Bayes' theorem: an evaluation using a computer simulation.

    Science.gov (United States)

    Chard, T

    1989-05-01

    A computer simulation is described which generates 'cases' of vaginal discharge. This simulation was used to evaluate the potential effects of dependence between clinical features on the diagnostic performance of Bayes' theorem. The following observations were made: (1) dependence between some but not all pairs of features reduced the overall diagnostic efficiency (judged by the number of true positive diagnoses); (2) the overall reduction in efficiency was never substantial; (3) the largest effects on the diagnosis of individual conditions was observed with rarer diseases, and with combinations of features which were inherently unlikely to be dependent. It is concluded that the diagnostic efficiency of Bayes' theorem will not be greatly influenced by dependence if a reasonable amount of commonsense is applied to the selection of the knowledge base.

  2. Evaluation of the Effectiveness of Chemical Dependency Counseling Course Based on Patrick and Partners

    Science.gov (United States)

    Keshavarz, Yousef; Ghaedi, Sina; Rahimi-Kashani, Mansure

    2012-01-01

    Background The twelve step program is one of the programs that are administered for overcoming abuse of drugs. In this study, the effectiveness of chemical dependency counseling course was investigated using a hybrid model. Methods In a survey with sample size of 243, participants were selected using stratified random sampling method. A questionnaire was used for collecting data and one sample t-test employed for data analysis. Findings Chemical dependency counseling courses was effective from the point of view of graduates, chiefs of rehabilitation centers, rescuers and their families and ultimately managers of rebirth society, but it was not effective from the point of view of professors and lecturers. The last group evaluated the effectiveness of chemical dependency counseling courses only in performance level. Conclusion It seems that the chemical dependency counseling courses had appropriate effectiveness and led to change in attitudes, increase awareness, knowledge and experience combination and ultimately increased the efficiency of counseling. PMID:24494132

  3. Evidence map of studies evaluating methods for conducting, interpreting and reporting overviews of systematic reviews of interventions: rationale and design.

    Science.gov (United States)

    Lunny, Carole; Brennan, Sue E; McDonald, Steve; McKenzie, Joanne E

    2016-01-06

    Overviews of systematic reviews attempt to systematically retrieve and summarise the results of multiple systematic reviews into a single document. Methods for conducting, interpreting and reporting overviews of reviews are in their infancy. To date, there has been no systematic review or evidence map examining the range of methods for overviews nor of the evidence for using these methods. The objectives of the study are to develop and populate a framework of methods that have or may be used in conducting, interpreting and reporting overviews of systematic reviews of interventions (stage I); create an evidence map of studies that have evaluated these methods (stage II); and identify and describe unique methodological challenges of overviews. The research will be undertaken in two stages. For both stages, we plan to search methods collections (e.g. Cochrane Methodology Register, Meth4ReSyn library, AHRQ Effective Health Care Program) to identify eligible studies. These searches will be supplemented by searching reference lists and citation searching. Stage I: Methods used in overviews will be identified from articles describing methods for overviews, methods studies examining a cross section/cohort of overviews, guidance documents and commentaries. The identified methods will populate a framework of available methods for conducting an overview. Two reviewers will independently code included studies to develop the framework. Thematic analysis of the coded data will be used to categorise and describe methods. Stage II: Evaluations of the performance of methods will be identified from systematic reviews of methods studies and methods studies. Evaluations will be described and mapped to the framework of methods identified in stage I. The results of this process will be useful for mapping of methods for overviews of systematic reviews, informing guidance and identifying and prioritising method research in this field.

  4. Evidence used in model-based economic evaluations for evaluating pharmacogenetic and pharmacogenomic tests: a systematic review protocol.

    Science.gov (United States)

    Peters, Jaime L; Cooper, Chris; Buchanan, James

    2015-11-11

    Decision models can be used to conduct economic evaluations of new pharmacogenetic and pharmacogenomic tests to ensure they offer value for money to healthcare systems. These models require a great deal of evidence, yet research suggests the evidence used is diverse and of uncertain quality. By conducting a systematic review, we aim to investigate the test-related evidence used to inform decision models developed for the economic evaluation of genetic tests. We will search electronic databases including MEDLINE, EMBASE and NHS EEDs to identify model-based economic evaluations of pharmacogenetic and pharmacogenomic tests. The search will not be limited by language or date. Title and abstract screening will be conducted independently by 2 reviewers, with screening of full texts and data extraction conducted by 1 reviewer, and checked by another. Characteristics of the decision problem, the decision model and the test evidence used to inform the model will be extracted. Specifically, we will identify the reported evidence sources for the test-related evidence used, describe the study design and how the evidence was identified. A checklist developed specifically for decision analytic models will be used to critically appraise the models described in these studies. Variations in the test evidence used in the decision models will be explored across the included studies, and we will identify gaps in the evidence in terms of both quantity and quality. The findings of this work will be disseminated via a peer-reviewed journal publication and at national and international conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Evidence used in model-based economic evaluations for evaluating pharmacogenetic and pharmacogenomic tests: a systematic review protocol

    Science.gov (United States)

    Peters, Jaime L; Cooper, Chris; Buchanan, James

    2015-01-01

    Introduction Decision models can be used to conduct economic evaluations of new pharmacogenetic and pharmacogenomic tests to ensure they offer value for money to healthcare systems. These models require a great deal of evidence, yet research suggests the evidence used is diverse and of uncertain quality. By conducting a systematic review, we aim to investigate the test-related evidence used to inform decision models developed for the economic evaluation of genetic tests. Methods and analysis We will search electronic databases including MEDLINE, EMBASE and NHS EEDs to identify model-based economic evaluations of pharmacogenetic and pharmacogenomic tests. The search will not be limited by language or date. Title and abstract screening will be conducted independently by 2 reviewers, with screening of full texts and data extraction conducted by 1 reviewer, and checked by another. Characteristics of the decision problem, the decision model and the test evidence used to inform the model will be extracted. Specifically, we will identify the reported evidence sources for the test-related evidence used, describe the study design and how the evidence was identified. A checklist developed specifically for decision analytic models will be used to critically appraise the models described in these studies. Variations in the test evidence used in the decision models will be explored across the included studies, and we will identify gaps in the evidence in terms of both quantity and quality. Dissemination The findings of this work will be disseminated via a peer-reviewed journal publication and at national and international conferences. PMID:26560056

  6. Evaluation by industrial workers of passive and level-dependent hearing protection devices.

    Science.gov (United States)

    Tufts, Jennifer B; Hamilton, Mark A; Ucci, Amanda J; Rubas, James

    2011-01-01

    Level-dependent hearing protection devices (HPDs) provide protection from intense sound, while offering amplification for speech and other signals in lower levels of noise. These HPDs have been developed in response to the communication and operational needs of noise-exposed persons in industry and the military. This study was conducted to examine industrial workers' perceptions of the performance of two level-dependent HPDs (one with integrated radio communication capability and one without it) and their customary passive HPDs. This research took place at a plastic film manufacturing plant in Rhode Island, USA, following a mixed-measures design. Fifteen maintenance technicians at the plant evaluated the two level-dependent HPDs, plus their customary passive HPDs, in three separate trial periods. Data were collected via a questionnaire designed for this purpose. Mixed-model analyses of variance were performed on all dependent measures. Linear and quadratic effect sizes were assessed with eta. Results revealed that the two level-dependent HPDs offered better perceived communication and situational awareness than the workers' customary passive HPDs. However, the level-dependent HPDs were rated lower than the passive HPDs in terms of usability and comfort. To increase workers' acceptance of level-dependent HPDs, usability issues must be addressed by the HPD manufacturers.

  7. Evaluation by industrial workers of passive and level-dependent hearing protection devices

    Directory of Open Access Journals (Sweden)

    Jennifer B Tufts

    2011-01-01

    Full Text Available Level-dependent hearing protection devices (HPDs provide protection from intense sound, while offering amplification for speech and other signals in lower levels of noise. These HPDs have been developed in response to the communication and operational needs of noise-exposed persons in industry and the military. This study was conducted to examine industrial workers′ perceptions of the performance of two level-dependent HPDs (one with integrated radio communication capability and one without it and their customary passive HPDs. This research took place at a plastic film manufacturing plant in Rhode Island, USA, following a mixed-measures design. Fifteen maintenance technicians at the plant evaluated the two level-dependent HPDs, plus their customary passive HPDs, in three separate trial periods. Data were collected via a questionnaire designed for this purpose. Mixed-model analyses of variance were performed on all dependent measures. Linear and quadratic effect sizes were assessed with eta. Results revealed that the two level-dependent HPDs offered better perceived communication and situational awareness than the workers′ customary passive HPDs. However, the level-dependent HPDs were rated lower than the passive HPDs in terms of usability and comfort. To increase workers′ acceptance of level-dependent HPDs, usability issues must be addressed by the HPD manufacturers.

  8. Evaluating overweight and obesity prevalence in survivors of childhood brain tumors: a systematic review protocol.

    Science.gov (United States)

    Wang, Kuan-Wen; Fleming, Adam; Singh, Sheila K; Banfield, Laura; de Souza, Russell J; Thabane, Lehana; Samaan, M Constantine

    2017-03-03

    Overweight and obesity are well-known risk factors for cardiometabolic diseases including hypertension, myocardial infarction, stroke, and type 2 diabetes in the general population. Survivors of childhood brain tumors (SCBT) are at risk of premature mortality, and recent evidence suggests that these cardiometabolic diseases are potential emerging determinants of survival and quality of life. Therefore, the rates of overweight and obesity in this population need to be examined to assess their impact on outcomes. The objective of this systematic review is to examine the prevalence of overweight and obesity in SCBT. The secondary aim of this review is to evaluate whether SCBT have higher adiposity compared to the general population. Searches will be conducted in MEDLINE, CINAHL, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PubMed, and Database of Abstracts of Reviews of Effect. For gray literature, we will search ProQuest Dissertations and Theses A&I and Web of Science. Two reviewers will independently screen all articles against predetermined eligibility criteria and complete data abstraction, risk of bias, and quality assessments. The primary outcome includes the prevalence of overweight or obesity. The secondary outcomes involve waist-to-hip ratio, waist-to-height ratio, body fat percentage, and skinfold thickness. Meta-analysis will be performed when two or more studies with similar design, populations, and outcomes are available. This review will summarize current data on the prevalence of overweight and obesity in SCBT. This will help the development of an understanding of the scale of overweight and obesity in this population and guide the design of interventions that will improve outcomes. PROSPERO CRD42016051035.

  9. A comprehensive and systematic evaluation framework for a parsimonious daily rainfall field model

    Science.gov (United States)

    Bennett, Bree; Thyer, Mark; Leonard, Michael; Lambert, Martin; Bates, Bryson

    2018-01-01

    The spatial distribution of rainfall has a significant influence on catchment dynamics and the generation of streamflow time series. However, there are few stochastic models that can simulate long sequences of stochastic rainfall fields continuously in time and space. To address this issue, the first goal of this study was to present a new parsimonious stochastic model that produces daily rainfall fields across the catchment. To achieve parsimony, the model used the latent-variable approach (because this parsimoniously simulates rainfall occurrences as well as amounts) and several other assumptions (including contemporaneous and separable spatiotemporal covariance structures). The second goal was to develop a comprehensive and systematic evaluation (CASE) framework to identify model strengths and weaknesses. This included quantitative performance categorisation that provided a systematic, succinct and transparent method to assess and summarise model performance over a range of statistics, sites, scales and seasons. The model is demonstrated using a case study from the Onkaparinga catchment in South Australia. The model showed many strengths in reproducing the observed rainfall characteristics with the majority of statistics classified as either statistically indistinguishable from the observed or within 5% of the observed across the majority of sites and seasons. These included rainfall occurrences/amounts, wet/dry spell distributions, annual volumes/extremes and spatial patterns, which are important from a hydrological perspective. One of the few weaknesses of the model was that the total annual rainfall in dry years (lower 5%) was overestimated by 15% on average over all sites. An advantage of the CASE framework was that it was able to identify the source of this overestimation was poor representation of the annual variability of rainfall occurrences. Given the strengths of this continuous daily rainfall field model it has a range of potential hydrological

  10. A process evaluation of systematic risk and needs assessment for caregivers in specialised palliative care.

    Science.gov (United States)

    Thomsen, Kia Toft; Guldin, Mai-Britt; Nielsen, Mette Kjærgaard; Ollars, Chaitali Laura; Jensen, Anders Bonde

    2017-04-08

    Caregiving is strenuous and it may be associated with adverse psychological outcomes. During the palliative care trajectory, there are unique opportunities for providing support and preventing poor bereavement outcome. However, the tasks of palliative care staff in relation to caregivers are often unclear in the daily practice. Assessment is recommended to establish risk and needs and standards for caregiver support are available. Still, the feasibility of applying these standards among caregivers in everyday clinical practice has not been tested so far. This study tested the feasibility of an intervention based on key elements of the "Bereavement support standards for specialist palliative care services" in a Danish specialised palliative home care team. We followed the UK Medical Research Council's guidelines for the process evaluation of complex interventions. The intervention consisted of: 1. Systematic risk and needs assessment for caregivers at care entry; 2. Interdisciplinary conference to prepare a support plan; 3. Targeted support; 4. The establishment of an electronic medical record for caregivers to document targeted support. Outcomes included the reach, fidelity and acceptability of the intervention as well as the assessment of contextual factors. The intervention reached 76 of 164 caregivers (46%). The interdisciplinary risk assessment and documentation of a support plan was conducted in 57 (75%) of the enrolled caregivers. Finally, a separate medical record was established according to the intervention blueprint for 62% of caregivers receiving targeted support. After managing initial challenges, palliative care staff reported that the intervention was useful and acceptable. The intervention proved feasible and useful. Still, we identified barriers to the implementation which should be taken into consideration when planning implementation of a systematic risk and needs assessment and in the establishment of medical records for caregivers.

  11. Reproducibility of studies on text mining for citation screening in systematic reviews: Evaluation and checklist.

    Science.gov (United States)

    Olorisade, Babatunde Kazeem; Brereton, Pearl; Andras, Peter

    2017-09-01

    Independent validation of published scientific results through study replication is a pre-condition for accepting the validity of such results. In computation research, full replication is often unrealistic for independent results validation, therefore, study reproduction has been justified as the minimum acceptable standard to evaluate the validity of scientific claims. The application of text mining techniques to citation screening in the context of systematic literature reviews is a relatively young and growing computational field with high relevance for software engineering, medical research and other fields. However, there is little work so far on reproduction studies in the field. In this paper, we investigate the reproducibility of studies in this area based on information contained in published articles and we propose reporting guidelines that could improve reproducibility. The study was approached in two ways. Initially we attempted to reproduce results from six studies, which were based on the same raw dataset. Then, based on this experience, we identified steps considered essential to successful reproduction of text mining experiments and characterized them to measure how reproducible is a study given the information provided on these steps. 33 articles were systematically assessed for reproducibility using this approach. Our work revealed that it is currently difficult if not impossible to independently reproduce the results published in any of the studies investigated. The lack of information about the datasets used limits reproducibility of about 80% of the studies assessed. Also, information about the machine learning algorithms is inadequate in about 27% of the papers. On the plus side, the third party software tools used are mostly free and available. The reproducibility potential of most of the studies can be significantly improved if more attention is paid to information provided on the datasets used, how they were partitioned and utilized, and

  12. Transient elastography for the diagnosis of liver fibrosis: a systematic review of economic evaluations.

    Science.gov (United States)

    van Katwyk, Sasha; Coyle, Doug; Cooper, Curtis; Pussegoda, Kusala; Cameron, Chris; Skidmore, Becky; Brener, Stacey; Moher, David; Thavorn, Kednapa

    2017-06-01

    Liver biopsy remains the gold standard for the diagnosis of liver fibrosis, but its use as a diagnostic tool is limited by its invasive nature and high cost. The aim of this study was to systematically review the cost-effectiveness of transient elastography (TE) with and without controlled attenuation parameter (CAP) for the diagnosis of liver fibrosis or steatosis in patients with hepatitis B, hepatitis C, alcoholic liver disease and non-alcoholic fatty liver disease. An economic literature search was performed. Eligibility criteria included systematic reviews, health technology assessments or economic evaluations of TE compared to liver biopsy and other non-invasive tests. After abstract screening, full-text reports of potentially relevant articles were assessed in duplicate. The methodological quality of the included studies was also appraised. The database search yielded 253 records; four cost-effectiveness and four cost-utility studies were included. The methodological quality of the included studies varies. High-quality cost-effectiveness studies not only suggested that TE is less costly but also less accurate than liver biopsy. The incremental cost-effectiveness ratio (ICER) of TE improves with a greater level of diagnostic accuracy and a higher degree of liver fibrosis. High-quality cost-utility studies indicated that TE is a cost-effective alternative to biopsy with ICER between $9000 and $14 000 per QALY for patients with hepatitis C. We did not find studies that assessed the cost-effectiveness of TE with CAP for the diagnosis of liver steatosis. Transient elastography is an economically attractive alternative to liver biopsy and other non-invasive diagnostic tests especially for patients with a higher degree of liver fibrosis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Evaluating the role of smokeless tobacco use indices as brief measures of dependence.

    Science.gov (United States)

    Mushtaq, Nasir; Beebe, Laura A

    2017-06-01

    There is considerable interest in using brief measures of dependence for evaluation and treatment of tobacco dependence. The Heaviness of Smoking Index (HSI) is a validated measure of dependence among cigarette smokers. However, a similar index has not been studied among ST users. The aim of this study is to develop similar ST use indices and evaluate their utility as concise dependence measures. Time to first chew/dip of the day (TTFD), number of cans of ST used per week (CPW), and number of dips/chews per day (DPD) were used to create three ST use indices; heaviness of ST use index (HSTI), ST dependence index (STDI), and ST quantity frequency index (ST-QFI). The study was based on data collected from a community based sample of exclusive ST users living in Oklahoma. Participants completed the self-administered survey which included dependence scales and questionnaires to measure sociodemographic factors and tobacco use characteristics. Saliva samples were obtained to measure cotinine concentration. Method of scoring for TTFD and DPD was similar to the scoring scheme employed for HSI items. DPD was transformed by a series of statistical tests into a three category scoring variable. Concurrent validity and reliability of the ST use indices were evaluated and overall accuracy of ST use indices was assessed. Level of agreement between the ST use indices and Fagerström Test for Nicotine Dependence for ST users (FTND-ST) was calculated to find the extent these indices were equivalent to FTND-ST in measuring dependence. ST use indices were significantly correlated with FTND-ST. ST users who had higher HSTI or STDI scores were more likely to have Tobacco Dependence Screener (TDS) based dependence diagnosis (OR: 1.50, 95%CI: 1.12, 2.02 and OR: 1.53, 95%CI: 1.16, 2.02, respectively). Study findings showed that all ST use indices were predictors of cotinine concentration. The internal consistency assessed by Cronbach's alpha indicated that STDI had acceptable reliability

  14. The Evaluation of Curative Effect of Acupuncture: A Review of Systematic and Meta-Analysis Studies.

    Science.gov (United States)

    Salehi, Alireza; Marzban, Maryam; Imanieh, Mohammad Hadi

    2016-07-01

    The present study attempts to critically evaluate previously published research articles on the efficiency of acupuncture in the treatment of diseases. First, 35 systematic reviews or meta-analysis were found in the Cochrane database. Second, 54 related articles were selected by searching important scientific databases. Based on the results obtained regarding the efficacy of acupuncture for the treatment of various diseases, the articles were divided into 3 groups. The first group of articles confirmed the efficacy of treatment by acupuncture. In the second group of articles, the therapeutic effect of acupuncture was shown; however, further research is required to verify the results. In the third group of articles there is no evidence regarding the therapeutic effect of acupuncture till now. There is an urgent need to design and conduct double-blinded randomized clinical trials with high-quality methodologies. This provides a more careful evaluation of acupuncture efficiency in relation to the treatment of a vast array of diseases, based on scientific evidence. © The Author(s) 2015.

  15. Volatile organic compounds in ventilated critical care patients: a systematic evaluation of cofactors.

    Science.gov (United States)

    Hüppe, Tobias; Lorenz, Dominik; Wachowiak, Mario; Maurer, Felix; Meiser, Andreas; Groesdonk, Heinrich; Fink, Tobias; Sessler, Daniel I; Kreuer, Sascha

    2017-08-22

    Expired gas (exhalome) analysis of ventilated critical ill patients can be used for drug monitoring and biomarker diagnostics. However, it remains unclear to what extent volatile organic compounds are present in gases from intensive care ventilators, gas cylinders, central hospital gas supplies, and ambient air. We therefore systematically evaluated background volatiles in inspired gas and their influence on the exhalome. We used multi-capillary column ion-mobility spectrometry (MCC-IMS) breath analysis in five mechanically ventilated critical care patients, each over a period of 12 h. We also evaluated volatile organic compounds in inspired gas provided by intensive care ventilators, in compressed air and oxygen from the central gas supply and cylinders, and in the ambient air of an intensive care unit. Volatiles detectable in both inspired and exhaled gas with patient-to-inspired gas ratios compounds. A total of 76 unique MCC-IMS signals were detected, with 39 being identified volatile compounds: 73 signals were from the exhalome, 12 were identified in inspired gas from critical care ventilators, and 34 were from ambient air. Five volatile compounds were identified from the central gas supply, four from compressed air, and 17 from compressed oxygen. We observed seven contaminating volatiles with patient-to-inspired gas ratios Volatile organic compounds can be present in gas from central hospital supplies, compressed gas tanks, and ventilators. Accurate assessment of the exhalome in critical care patients thus requires frequent profiling of inspired gases and appropriate normalisation of the expired signals.

  16. Tear film evaluation and management in soft contact lens wear: a systematic approach.

    Science.gov (United States)

    Downie, Laura E; Craig, Jennifer P

    2017-09-01

    The human tear film is a highly ordered structure consisting of a thin layer of lipid on the surface and a thicker aqueous-mucin phase, which increases in mucin concentration toward the corneal epithelial cell layer. The health of the tear film and ocular surface influences the likelihood of being able to achieve successful contact lens wear. Contact lens discomfort and dryness are the most frequent reasons why contact lens wearers experience reduced wearing times, which can eventually lead to contact lens discontinuation. Comprehensive clinical assessment of tear film integrity and ocular surface health is therefore essential prior to commencing contact lens wear, to enable the ocular surface environment to be optimised to support lens wear. These parameters should also be evaluated over the course of contact lens wear, in order to identify any aspects requiring clinical management and ensure maintenance of optimal lens-wearing conditions. This review summarises current knowledge relating to the effects of soft contact lens wear on the tear film and ocular surface. It also provides a systematic approach to evaluating tear film and ocular surface integrity, in order to guide the clinical management of tear film anomalies with respect to contact lens wear. © 2017 Optometry Australia.

  17. Evaluation of physical activity in the health promotion for brazilian teenagers: a systematic review

    Directory of Open Access Journals (Sweden)

    Alvaro Adolfo Duarte Alberto

    2014-05-01

    Full Text Available Objective: To analyze the methodological designs of national studies that assessed the level of physical activity for promoting adolescent health. Methods: a systematic literature review of original researches and publications of MEDLINE, LILACS, SCOPUS and ADOLEC electronic databases. It focused on determinant aspects of physical activity for health promotion using the following keywords: physical activity, physical fitness, physical activity, physical exercise, motor activity, sedentary and sedentariness, adolescent, adolescence, young, youth, teenager, and teenage, Brazil, Brazilian, South America, Low-middle income and country(ies. Data analysis covered the period from 2005 to 2011. First, 449 studies were identified. After analyzing the titles of the manuscripts, 130 articles were eligible for abstract evaluation and subsequent full text analysis. In the end, 31 articles met all inclusion criteria. Results: A total of 93.6% (n=29 of the evaluated studies used cross-sectional design, with samples ranging from 92 to 5028 subjects, and all of them used questionnaires for measuring physical activity. The main analysis of the studies was based on the association between physical activity, biodemographic data (age, gender and socioeconomic data (income, social class and parental education. Conclusion: The national studies assessing the level of physical activity for promoting adolescent health appear with great methodological variability since there is no standardization in the methodological design, instrument and definition of variables, highlighting the need for longitudinal studies in this area. doi:10.5020/18061230.2013.p426

  18. Evaluation of Implant Collar Surfaces for Marginal Bone Loss: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Roodabeh Koodaryan

    2016-01-01

    Full Text Available Background. It is important to understand the influence of different collar designs on peri-implant marginal bone loss, especially in the critical area. Objectives. The purpose of the present systematic review and meta-analysis was to compare dental implants with different collar surfaces, evaluating marginal bone loss and survival rates of implants. Methods. Eligibility criteria included clinical human studies, randomized controlled trials, and prospective and retrospective studies, which evaluated dental implants with different collar surface in the same study. Results. Twelve articles were included, with a total of 492 machined, 319 rough-surfaced, and 352 rough-surfaced microthreaded neck implants. There was less marginal bone loss at implants with rough-surfaced and rough-surfaced microthreaded neck than at machined-neck implants (difference in means: 0.321, 95% CI: 0.149 to 0.493; p<0.01. Conclusion. Rough and rough-surfaced microthreaded implants are considered a predictable treatment for preserving early marginal bone loss.

  19. Multitask protocols to evaluate activities of daily living performance in people with COPD: a systematic review.

    Science.gov (United States)

    Paes, Thaís; Machado, Felipe Vilaça Cavallari; Cavalheri, Vinícius; Pitta, Fabio; Hernandes, Nidia Aparecida

    2017-07-01

    People with chronic obstructive pulmonary disease (COPD) present symptoms such as dyspnea and fatigue, which hinder their performance in activities of daily living (ADL). A few multitask protocols have been developed to assess ADL performance in this population, although measurement properties of such protocols were not yet systematically reviewed. Areas covered: Studies were included if an assessment of the ability to perform ADL was conducted in people with COPD using a (objective) performance-based protocol. The search was conducted in the following databases: Pubmed, EMBASE, Cochrane Library, PEDro, CINAHL and LILACS. Furthermore, hand searches were conducted. Expert commentary: Up to this moment, only three protocols had measurement properties described: the Glittre ADL Test, the Monitored Functional Task Evaluation and the Londrina ADL Protocol were shown to be valid and reliable whereas only the Glittre ADL Test was shown to be responsive to change after pulmonary rehabilitation. These protocols can be used in laboratory settings and clinical practice to evaluate ADL performance in people with COPD, although there is need for more in-depth information on their validity, reliability and especially responsiveness due to the growing interest in the accurate assessment of ADL performance in this population.

  20. Load Index Metrics for an Optimized Management of Web Services: A Systematic Evaluation

    Science.gov (United States)

    Souza, Paulo S. L.; Santana, Regina H. C.; Santana, Marcos J.; Zaluska, Ed; Faical, Bruno S.; Estrella, Julio C.

    2013-01-01

    The lack of precision to predict service performance through load indices may lead to wrong decisions regarding the use of web services, compromising service performance and raising platform cost unnecessarily. This paper presents experimental studies to qualify the behaviour of load indices in the web service context. The experiments consider three services that generate controlled and significant server demands, four levels of workload for each service and six distinct execution scenarios. The evaluation considers three relevant perspectives: the capability for representing recent workloads, the capability for predicting near-future performance and finally stability. Eight different load indices were analysed, including the JMX Average Time index (proposed in this paper) specifically designed to address the limitations of the other indices. A systematic approach is applied to evaluate the different load indices, considering a multiple linear regression model based on the stepwise-AIC method. The results show that the load indices studied represent the workload to some extent; however, in contrast to expectations, most of them do not exhibit a coherent correlation with service performance and this can result in stability problems. The JMX Average Time index is an exception, showing a stable behaviour which is tightly-coupled to the service runtime for all executions. Load indices are used to predict the service runtime and therefore their inappropriate use can lead to decisions that will impact negatively on both service performance and execution cost. PMID:23874776

  1. Dependence measures for non-cigarette tobacco products within the context of the global epidemic: a systematic review.

    Science.gov (United States)

    De Leon, Elaine; Smith, Katherine Clegg; Cohen, Joanna E

    2014-05-01

    Validated metrics of tobacco dependence exist, but their value for global surveillance of tobacco dependence and development of tobacco control interventions is not well understood. This paper reviews tobacco dependence metrics for non-cigarette products, and whether measures of tobacco dependence have been validated in low-income and middle-income countries (LMIC). Searches were conducted in PubMed, Scopus, PsycINFO, EMBASE, CINAHL and Global Health databases using variant terms for types of tobacco, dependence, measures and validity/reliability. Articles discussing dependence theories and/or metrics were fully reviewed and synthesised. Searches yielded 2702 unique articles. Two independent coders identified 587 articles for abstract review, and 229 were subsequently fully reviewed. Findings from 50 eligible papers are summarised. An initial thematic analysis concentrated on four concepts: general tobacco dependence, dependence metrics, tobacco dependence in LMIC and dependence on non-cigarette tobacco. Analysis identified 14 distinct tobacco dependence instruments. Existing metrics treat tobacco dependence as multifaceted. Measures have been developed almost exclusively around cigarette smoking, although some validation and application across products has occurred. Where cross-national validation has occurred, however, this has rarely included LMIC. For purposes of global surveillance of tobacco dependence, there is a compelling need for validated measures to apply universally across social contexts and a multitude of tobacco products. Alternatively, effective tobacco control interventions require validated dependence measures that integrate specific behavioural elements and social context of product use. While different measures of dependence are required to fulfil each of these goals, both have value in addressing the global tobacco epidemic.

  2. Evaluation Methods for Assessing Users’ Psychological Experiences of Web-Based Psychosocial Interventions: A Systematic Review

    Science.gov (United States)

    Howson, Moira; Ritchie, Linda; Carter, Philip D; Parry, David Tudor; Koziol-McLain, Jane

    2016-01-01

    Background The use of Web-based interventions to deliver mental health and behavior change programs is increasingly popular. They are cost-effective, accessible, and generally effective. Often these interventions concern psychologically sensitive and challenging issues, such as depression or anxiety. The process by which a person receives and experiences therapy is important to understanding therapeutic process and outcomes. While the experience of the patient or client in traditional face-to-face therapy has been evaluated in a number of ways, there appeared to be a gap in the evaluation of patient experiences of therapeutic interventions delivered online. Evaluation of Web-based artifacts has focused either on evaluation of experience from a computer Web-design perspective through usability testing or on evaluation of treatment effectiveness. Neither of these methods focuses on the psychological experience of the person while engaged in the therapeutic process. Objective This study aimed to investigate what methods, if any, have been used to evaluate the in situ psychological experience of users of Web-based self-help psychosocial interventions. Methods A systematic literature review was undertaken of interdisciplinary databases with a focus on health and computer sciences. Studies that met a predetermined search protocol were included. Results Among 21 studies identified that examined psychological experience of the user, only 1 study collected user experience in situ. The most common method of understanding users’ experience was through semistructured interviews conducted posttreatment or questionnaires administrated at the end of an intervention session. The questionnaires were usually based on standardized tools used to assess user experience with traditional face-to-face treatment. Conclusions There is a lack of methods specified in the literature to evaluate the interface between Web-based mental health or behavior change artifacts and users. Main

  3. Review and evaluation of online tobacco dependence treatment training programs for health care practitioners.

    Science.gov (United States)

    Selby, Peter; Goncharenko, Karina; Barker, Megan; Fahim, Myra; Timothy, Valerie; Dragonetti, Rosa; Kemper, Katherine; Herie, Marilyn; Hays, J Taylor

    2015-04-17

    Training health care professionals is associated with increased capacity to deliver evidence-based smoking cessation interventions and increased quit rates among their patients. Online training programs hold promise to provide training but questions remain regarding the quality and usability of available programs. The aim was to assess the quality of English-language online courses in tobacco dependence treatment using a validated instrument. An environmental scan was conducted using the Google search engine to identify available online tobacco dependence treatment courses. The identified courses were then evaluated using the Peer Review Rubric for Online Learning, which was selected based on its ability to evaluate instructional design. It also has clear and concise criteria descriptions to ensure uniformity of evaluations by trained experts. A total of 39 courses were identified, of which 24 unique courses were assessed based on their accessibility and functionality during the period of evaluation. Overall, the course ratings indicated that 17 of 24 courses evaluated failed to meet minimal quality standards and none of the courses evaluated could be ranked as superior. However, many excelled in providing effective navigation, course rationale, and content. Many were weak in the use of instructional design elements, such as teaching effectiveness, learning strategies, instructor's role, and assessment and evaluation. Evaluation results and suggestions for improvement were shared with course administrators. Based on the courses evaluated in this review, course developers are encouraged to employ best practices in instructional design, such as cohesiveness of material, linearity of design, practice exercises, problem solving, and ongoing evaluation to improve existing courses and in the design of new online learning opportunities.

  4. Is inertial flywheel resistance training superior to gravity-dependent resistance training in improving muscle strength? A systematic review with meta-analyses.

    Science.gov (United States)

    Vicens-Bordas, J; Esteve, E; Fort-Vanmeerhaeghe, A; Bandholm, T; Thorborg, K

    2017-10-18

    The primary aim of this systematic review was to determine if inertial flywheel resistance training is superior to gravity-dependent resistance training in improving muscle strength. The secondary aim was to determine whether inertial flywheel resistance training is superior to gravity-dependent resistance training in improving other muscular adaptations. A systematic review with meta-analyses of randomised and non-randomised controlled trials. We searched MEDLINE, Scopus, SPORTDiscus, Web of Science and Cochrane Central Register of Controlled Trials with no publication date restrictions until November 2016. We performed meta-analyses on randomised and non-randomised controlled trials to determine the standardized mean difference between the effects of inertial flywheel and gravity-dependent resistance training on muscle strength. A total of 76 and 71 participants were included in the primary and secondary analyses, respectively. After systematic review, we included three randomised and four non-randomised controlled trials. In the primary analysis for the primary outcome muscle strength, the pooled results from randomised controlled trials showed no difference (SMD=-0.05; 95%CI -0.51 to 0.40; p=0.82; I2=0%). In the secondary analyses of the primary outcome, the pooled results from non-randomised controlled trials showed no difference (SMD=0.02; 95%CI -0.45 to 0.49; p=0.93; I2=0%; and SMD=0.03; 95%CI -0.43 to 0.50; p=0.88; I2=0%). Meta-analysis on secondary outcomes could not be performed. Based on the available data, inertial flywheel resistance training was not superior to gravity-dependent resistance training in enhancing muscle strength. Data for other strength variables and other muscular adaptations was insufficient to draw firm conclusions from. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  5. A Pitfall in evluating Systematic Errors

    CERN Document Server

    Linnenmann, James T

    2008-01-01

    A common practice in evaluating the contribution of systematic uncertainties is to change the parameter by ±1 of systematic uncertainty, then to add the induced changes in the result in quadrature. This is typically justi ed by arguing that the individual systematic effects are statistically independent. However, if the response to one parameter depends on the value of another parameter ("interaction" in the statistical Design of Experiments jargon), a signi cant portion of the actual uncertainty may be missed by applying the usual formula. In particular, any terms such as xy are completely missed unless more than one systematic parameter is varied in a single evaluation.

  6. [The methods within the evaluation of disease management programmes in control-group designs using the example of diabetes mellitus - a systematic literature review].

    Science.gov (United States)

    Drabik, A; Sawicki, P T; Müller, D; Passon, A; Stock, S

    2012-08-01

    Disease management programmes (DMPs) were implemented in Germany in 2002. Their evaluation is required by law. Beyond the mandatory evaluation, a growing number of published studies evaluate the DMP for diabetes mellitus type 2 in a control-group design. As patients opt into the programme on a voluntary basis it is necessary to adjust the inherent selection bias between groups. The aim of this study is to review published studies which evaluate the diabetes DMP using a control-group design with respect to the methods used. A systematic literature review of electronic databases (PUBMED, Cochrane Library, EMBASE, MEDPILOT) and a hand search of reference lists of the relevant publications was conducted to identify studies evaluating the DMP diabetes mellitus in a control-group design. 8 studies were included in the systematic literature review. 4 studies gathered retrospective claims data from sickness funds, one from physician's records, one study used prospective data from ambulatory care, and 2 studies were based on one patient survey. Methods used for adjustment of selection bias included exact matching, matching using propensity score methods, age-adjusted and sex-separated analysis, and adjustment in a regression model/analysis of covariance. One study did not apply adjustment methods. The intervention period ranged from 1 day to 4 years. Considered outcomes of studies (surrogate parameter, diabetes complications, mortality, quality of life, and claim data) depended on the database. In the evaluation of the DMP diabetes mellitus based on a control-group design neither the database nor the methods used for selection bias adjustment were consistent in the available studies. Effectiveness of DMPs cannot be judged based on this review due to heterogeneity of study designs. To allow for a comprehensive programme evaluation standardised minimum requirements for the evaluation of DMPs in the control group design are required. © Georg Thieme Verlag KG Stuttgart · New

  7. Dependency of illness evaluation on the social comparison context: findings with implicit measures of affective evaluation of asthma.

    Science.gov (United States)

    Petersen, Sibylle; Ritz, Thomas

    2010-05-01

    The affective dimension of illness representation plays an important role in asthma self-management. However, little is known about the stability of this affective representation across contexts. We explored the role of social comparison in this affective evaluation. Participants included 20 individuals reporting an asthma diagnosis and 33 healthy controls. To measure asthma attitudes, we used three different versions of the Implicit Association Test (IAT), a single target IAT (ST-IAT) and two IATs with different social comparison standards for asthma evaluation (1) HIV and (2) diabetes. Reaction times to pair asthma with positive or negative word stimuli in the three IATs were compared in a repeated measure ANOVA. Furthermore, the relationship between affective evaluation, self-reported asthma-specific coping, and negative affect was explored. Individuals reporting an asthma diagnosis showed a stronger negative evaluation of asthma than healthy individuals in the ST-IAT. This negative evaluation was positively related to the self-report of dysfunctional coping strategies. However, in the IAT introducing a downward social comparison with HIV, evaluation of asthma was less negative and no longer positively related to the report of dysfunctional coping. Downward social comparison can buffer against negative affective evaluation of asthma. The context dependency of illness-related attitudes requires attention in future research and asthma management practice.

  8. A systematic evaluation of the effect of thumb opponens splints on hand function in children with unilateral spastic cerebral palsy

    NARCIS (Netherlands)

    Ten Berge, S.R.; Boonstra, Antje; Dijkstra, P.U.; Hadders-Algra, M.; Haga, N.; Maathuis, C.G.B.

    Objective: To examine the effects of a neoprene thumb opponens splint on hand function during a self-selected activities of daily living task in children with unilateral spastic cerebral palsy with thumb-in-palm position of the affected hand. Design: Systematic evaluation of seven cases using a

  9. Systematic Review of Educational Interventions for Looked-After Children and Young People: Recommendations for Intervention Development and Evaluation

    Science.gov (United States)

    Evans, Rhiannon; Brown, Rachel; Rees, Gwyther; Smith, Philip

    2017-01-01

    Looked-after children and young people (LACYP) are educationally disadvantaged compared to the general population. A systematic review was conducted of randomised controlled trials evaluating interventions aimed at LACYP aged =18 years. Restrictions were not placed on delivery setting or delivery agent. Intervention outcomes were: academic skills;…

  10. Reduction in uptake of PSA tests following decision aids: systematic review of current aids and their evaluations.

    NARCIS (Netherlands)

    Evans, R.; Edwards, A.; Brett, J.; Bradburn, M.; Watson, E.; Austoker, J.; Elwyn, G.

    2005-01-01

    A man's decision to have a prostate-specific antigen (PSA) test should be an informed one. We undertook a systematic review to identify and appraise PSA decision aids and evaluations. We searched 15 electronic databases and hand-searched key journals. We also contacted key authors and organisations.

  11. A systematic method for using 3D echocardiography to evaluate tricuspid valve insufficiency in hypoplastic left heart syndrome

    Directory of Open Access Journals (Sweden)

    Christopher Robin Mart

    2014-01-01

    We have proposed a systematic method for evaluating and displaying the TV using 3DE which can provide significant insight into the mechanisms causing TVI in HLHS. This has the potential to improve both the surgical approach to repairing the valve and, ultimately, patient outcomes.

  12. Psychometric evaluation of commonly used game-specific skills tests in rugby: A systematic review.

    Science.gov (United States)

    Oorschot, Sander; Chiwaridzo, Matthew; Cm Smits-Engelsman, Bouwien

    2017-01-01

    To (1) give an overview of commonly used game-specific skills tests in rugby and (2) evaluate available psychometric information of these tests. The databases PubMed, MEDLINE CINAHL and Africa Wide information were systematically searched for articles published between January 1995 and March 2017. First, commonly used game-specific skills tests were identified. Second, the available psychometrics of these tests were evaluated and the methodological quality of the studies assessed using the Consensus-based Standards for the selection of health Measurement Instruments checklist. Studies included in the first step had to report detailed information on the construct and testing procedure of at least one game-specific skill, and studies included in the second step had additionally to report at least one psychometric property evaluating reliability, validity or responsiveness. 287 articles were identified in the first step, of which 30 articles met the inclusion criteria and 64 articles were identified in the second step of which 10 articles were included. Reactive agility, tackling and simulated rugby games were the most commonly used tests. All 10 studies reporting psychometrics reported reliability outcomes, revealing mainly strong evidence. However, all studies scored poor or fair on methodological quality. Four studies reported validity outcomes in which mainly moderate evidence was indicated, but all articles had fair methodological quality. Game-specific skills tests indicated mainly high reliability and validity evidence, but the studies lacked methodological quality. Reactive agility seems to be a promising domain, but the specific tests need further development. Future high methodological quality studies are required in order to develop valid and reliable test batteries for rugby talent identification. PROSPERO CRD42015029747.

  13. Economic Evaluation of Family Planning Interventions in Low and Middle Income Countries; A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Neily Zakiyah

    Full Text Available A significant number of women in low and middle income countries (L-MICs who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research.A systematic review was performed in several electronic databases i.e Medline (Pubmed, Embase, Popline, The National Bureau of Economic Research (NBER, EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS statement.From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors.Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved reporting quality are necessary

  14. Performance of ultraviolet photocatalytic oxidation for indoor air applications: Systematic experimental evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Zhong, Lexuan [Department of Building, Civil and Environmental Engineering, Concordia University, Montreal, Quebec H3G 1M8 (Canada); Haghighat, Fariborz, E-mail: fariborz.haghighat@concordia.ca [Department of Building, Civil and Environmental Engineering, Concordia University, Montreal, Quebec H3G 1M8 (Canada); Lee, Chang-Seo [Department of Building, Civil and Environmental Engineering, Concordia University, Montreal, Quebec H3G 1M8 (Canada); Lakdawala, Ness [DECTRON International Inc., Montreal, Quebec (Canada)

    2013-10-15

    Highlights: • An innovative experimental set-up was designed and constructed for testing UV-PCO. • Test methodologies were developed to examine UV-PCO air cleaners for VOCs removal. • VOCs type, inlet concentration, flow rate, irradiance, and RH have influence on PCO. • Gas-phase ozonation with a variety of compounds was examined in a duct system. • Formation of by-products generated from incomplete conversion was investigated. -- Abstract: Photocatalytic oxidation (PCO) is a promising technology that has potential to be applied in mechanically ventilated buildings to improve indoor air quality (IAQ). However, the major research studies were done in bench-top scale reactors under ideal reaction conditions. In addition, no study has been carried out on the investigation of the ozonation and photolysis effect using a pilot duct system. The objective of this study is the development of methodologies to evaluate the performance of PCO systems. A systematic parametric evaluation of the effects of various kinetic parameters, such as compound's type, inlet concentration, airflow rate, light intensity, and relative humidity, was conducted, and new interpretations were provided from a fundamental analysis. In addition, the photolysis effect under vacuum ultraviolet (VUV) irradiation for a variety of volatile organic compounds (VOCs) was examined for the first time in a pilot duct system. The performance comparison of ultraviolet C (UVC)-PCO and VUV-PCO was also discussed due to the presence of ozone. Moreover, the formation of by-products generated with or without ozone generation was fully compared to evaluate the PCO technology.

  15. Economic evaluations of Haemophilus influenzae type b (Hib) vaccine: a systematic review.

    Science.gov (United States)

    Chongmelaxme, Bunchai; Hammanee, Maythika; Phooaphirak, Wariya; Kotirum, Surachai; Hutubessy, Raymond; Chaiyakunapruk, Nathorn

    2017-10-01

    The World Health Organization (WHO) recommends the use of Haemophilus influenzae type b (Hib) conjugate vaccines, but China and Thailand have not used Hib vaccination in their national immunization programs. This systematic review aimed to update published economic evaluations of Hib vaccinations and to determine factors that potentially affected their cost-effectiveness. Searches were performed from the inception until December 2015 using 13 databases: CAB direct; CEA registry; EconLit; EMBASE; E-library; NHSEED; PAHO; POPLINE; PubMed; Redalyc project; RePEc; SciELO; and WHOLIS. Reference lists of relevant studies and grey literature were also searched. Full economic evaluations of Hib vaccination with results of costs and outcomes were included. The WHO checklist was used to evaluate the quality of the included studies. Data from eligible studies were extracted using a standardized data collection form. Out of 830 articles, 27 were included. Almost half of the studies (12/27) were conducted in high-income countries. Twelve studies (12/27) investigated the Hib vaccine as an addition to the existing vaccination program. Most studies (17/27) examined a 3-dose schedule of Hib vaccine. Nineteen studies (19/27) reported the model used, where all were decision tree models. Most of the studies (23/27) demonstrated an economic value of Hib vaccination programs, key influential parameters being incidence rates of Hib disease and vaccine price. Hib vaccination programs are mostly found to be cost-effective across geographic regions and country income levels, and Hib vaccination is recommended for inclusion into all national immunization programs. The findings are expected to support policy-makers for making decisions on allocating limited resources of the Hib vaccination program effectively.

  16. Economic Evaluation of Family Planning Interventions in Low and Middle Income Countries; A Systematic Review.

    Science.gov (United States)

    Zakiyah, Neily; van Asselt, Antoinette D I; Roijmans, Frank; Postma, Maarten J

    2016-01-01

    A significant number of women in low and middle income countries (L-MICs) who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research. A systematic review was performed in several electronic databases i.e Medline (Pubmed), Embase, Popline, The National Bureau of Economic Research (NBER), EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors. Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved reporting quality are necessary to generate

  17. Applying the Analytic Hierarchy Process in healthcare research: A systematic literature review and evaluation of reporting.

    Science.gov (United States)

    Schmidt, Katharina; Aumann, Ines; Hollander, Ines; Damm, Kathrin; von der Schulenburg, J-Matthias Graf

    2015-12-24

    The Analytic Hierarchy Process (AHP), developed by Saaty in the late 1970s, is one of the methods for multi-criteria decision making. The AHP disaggregates a complex decision problem into different hierarchical levels. The weight for each criterion and alternative are judged in pairwise comparisons and priorities are calculated by the Eigenvector method. The slowly increasing application of the AHP was the motivation for this study to explore the current state of its methodology in the healthcare context. A systematic literature review was conducted by searching the Pubmed and Web of Science databases for articles with the following keywords in their titles or abstracts: "Analytic Hierarchy Process," "Analytical Hierarchy Process," "multi-criteria decision analysis," "multiple criteria decision," "stated preference," and "pairwise comparison." In addition, we developed reporting criteria to indicate whether the authors reported important aspects and evaluated the resulting studies' reporting. The systematic review resulted in 121 articles. The number of studies applying AHP has increased since 2005. Most studies were from Asia (almost 30%), followed by the US (25.6%). On average, the studies used 19.64 criteria throughout their hierarchical levels. Furthermore, we restricted a detailed analysis to those articles published within the last 5 years (n = 69). The mean of participants in these studies were 109, whereas we identified major differences in how the surveys were conducted. The evaluation of reporting showed that the mean of reported elements was about 6.75 out of 10. Thus, 12 out of 69 studies reported less than half of the criteria. The AHP has been applied inconsistently in healthcare research. A minority of studies described all the relevant aspects. Thus, the statements in this review may be biased, as they are restricted to the information available in the papers. Hence, further research is required to discover who should be interviewed and how, how

  18. Systematic review on the evaluation criteria of orphan medicines in Central and Eastern European countries.

    Science.gov (United States)

    Zelei, Tamás; Molnár, Mária J; Szegedi, Márta; Kaló, Zoltán

    2016-06-04

    In case of orphan drugs applicability of the standard health technology assessment (HTA) process is limited due to scarcity of good clinical and health economic evidence. Financing these premium priced drugs is more controversial in the Central and Eastern European (CEE) region where the public funding resources are more restricted, and health economic justification should be an even more important aspect of policy decisions than in higher income European countries. To explore and summarize the recent scientific evidence on value drivers related to the health technology assessment of ODs with a special focus on the perspective of third party payers in CEE countries. The review aims to list all potentially relevant value drivers in the reimbursement process of orphan drugs. A systematic literature review was performed; PubMed and Scopus databases were systematically searched for relevant publications until April 2015. Extracted data were summarized along key HTA elements. From the 2664 identified publications, 87 contained relevant information on the evaluation criteria of orphan drugs, but only 5 had direct information from the CEE region. The presentation of good clinical evidence seems to play a key role especially since this should be the basis of cost-effectiveness analyses, which have more importance in resource-constrained economies. Due to external price referencing of pharmaceuticals, the relative budget impact of orphan drugs is expected to be higher in CEE than in Western European (WE) countries unless accessibility of patients remains more limited in poorer European regions. Equity principles based on disease prevalence and non-availability of alternative treatment options may increase the price premium, however, societies must have some control on prices and a rationale based on multiple criteria in reimbursement decisions. The evaluation of orphan medicines should include multiple criteria to appropriately measure the clinical added value of orphan

  19. Conflicts of Interest in Medicine. A Systematic Review of Published and Scientifically evaluated Curricula.

    Science.gov (United States)

    Weißkircher, Janosch; Koch, Cora; Dreimüller, Nadine; Lieb, Klaus

    2017-01-01

    Objective: Conflicts of interests resulting from interactions with pharmaceutical companies are pervasive in medicine and can result in an undue influence on physicians' decision-making. The objective of this systematic review is to analyze published and scientifically evaluated curricula for medical students and residents regarding such conflicts of interest. We begin by describing the covered topics and teaching methods; afterwards we analyze the quality of the curricula using the published data on their evaluations and comparing the content with content recommended for such curricula. Methods: We searched Pubmed, PsycInfo, EMBASE, OECD, WISO, SOWI and googlescholar up to and including the 5th of September 2016. Publications describing curricula for residents or medical students on the topic of conflicts of interest in medicine and evaluating them for their effects on the participants' learning were included. We analyzed the covered topics and the teaching methods used and compared them with recommendations by the American Medical Students' Association (AMSA) and Health Action International (HAI). Results: The literature search resulted in 20 publications that fulfilled our search criteria. In five trials, a control group was used, in no trial the participants were randomized to intervention or control group. 16/20 published curricula primarily covered marketing strategies by pharmaceutical companies, especially the interaction with pharmaceutical sales representatives (PSRs). Most curricula only covered a limited number of topics recommended by AMSA/HAI. The most frequent teaching method was a group discussion, which was used in 18/20 curricula; all curricula used at least one interactive teaching method. The evaluation of the curricula was heterogeneous in results as well as design. Some publications described a change of attitudes toward a stronger skepticism regarding interactions with pharmaceutical companies. Four publications described improved knowledge

  20. Conflicts of Interest in Medicine. A Systematic Review of Published and Scientifically evaluated Curricula

    Directory of Open Access Journals (Sweden)

    Weißkircher, Janosch

    2017-08-01

    Full Text Available Objective: Conflicts of interests resulting from interactions with pharmaceutical companies are pervasive in medicine and can result in an undue influence on physicians’ decision-making. The objective of this systematic review is to analyze published and scientifically evaluated curricula for medical students and residents regarding such conflicts of interest. We begin by describing the covered topics and teaching methods; afterwards we analyze the quality of the curricula using the published data on their evaluations and comparing the content with content recommended for such curricula.Methods: We searched Pubmed, PsycInfo, EMBASE, OECD, WISO, SOWI and googlescholar up to and including the 5th of September 2016. Publications describing curricula for residents or medical students on the topic of conflicts of interest in medicine and evaluating them for their effects on the participants’ learning were included. We analyzed the covered topics and the teaching methods used and compared them with recommendations by the American Medical Students’ Association (AMSA and Health Action International (HAI. Results: The literature search resulted in 20 publications that fulfilled our search criteria. In five trials, a control group was used, in no trial the participants were randomized to intervention or control group. 16/20 published curricula primarily covered marketing strategies by pharmaceutical companies, especially the interaction with pharmaceutical sales representatives (PSRs. Most curricula only covered a limited number of topics recommended by AMSA/HAI. The most frequent teaching method was a group discussion, which was used in 18/20 curricula; all curricula used at least one interactive teaching method. The evaluation of the curricula was heterogeneous in results as well as design. Some publications described a change of attitudes toward a stronger skepticism regarding interactions with pharmaceutical companies. Four publications

  1. Evaluation of the forward Compton scattering off protons: II. Spin-dependent amplitude and observables

    OpenAIRE

    Gryniuk, Oleksii; Hagelstein, Franziska; Pascalutsa, Vladimir

    2016-01-01

    The forward Compton scattering off the proton is determined by substituting the empirical total photoabsorption cross sections into dispersive sum rules. In addition to the spin-independent amplitude evaluated previously [Phys. Rev. D 92, 074031 (2015)], we obtain the spin-dependent amplitude over a broad energy range. The two amplitudes contain all the information about this process, and we, hence, can reconstruct the nonvanishing observables of the proton Compton scattering in the forward k...

  2. Assessing clinical trials of Internet addiction treatment: a systematic review and CONSORT evaluation.

    Science.gov (United States)

    King, Daniel L; Delfabbro, Paul H; Griffiths, Mark D; Gradisar, Michael

    2011-11-01

    Although there is ongoing debate concerning the clinical status of Internet addiction, and the quality of the extant literature in this emerging field is not optimal, several clinical trials of both pharmacological and psychological treatments for Internet addiction have been published in recent years. A systematic review investigating the reporting quality of eight treatment studies is presented. Reporting quality was defined according to the 2010 Consolidating Standards of Reporting Trials (CONSORT) statement. An evaluation of the reviewed studies highlighted several key limitations, including (a) inconsistencies in the definition and diagnosis of Internet addiction, (b) a lack of randomization and blinding techniques, (c) a lack of adequate controls or other comparison groups, and (d) insufficient information concerning recruitment dates, sample characteristics, and treatment effect sizes. It is concluded that improvements in future studies' design and reporting would be of significant benefit to both researchers and clinicians, and to the overall positioning of Internet addiction in the behavioral addiction field. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Check-in/check-out: a systematic evaluation and component analysis.

    Science.gov (United States)

    Campbell, Amy; Anderson, Cynthia M

    2011-01-01

    Tier 2 interventions are implemented similarly across students and thus serve as an efficient and cost-effective method of behavior support in school settings. Check-in/check-out is a Tier 2 intervention with documented effectiveness (e.g., Hawken & Horner, 2003; Todd, Campbell, Meyer, & Horner, 2008). Key features of the intervention include brief morning and afternoon meetings with the intervention coordinator, use of a point card on which the teacher monitors student behavior, and teacher feedback at predetermined times. The present study sought to add to the literature by examining the relative contributions of the teacher-feedback components of check-in/check-out via the use of a component analysis. Working with 4 children in a general education setting, we first evaluated the effectiveness of the procedure using reversal designs. Next, we systematically removed teacher-feedback components to assess effects on problem behavior and academic engagement. For 3 of 4 participants, we were able to remove all teacher-feedback sessions and the point card; for the 4th participant, we removed only 2 of 3 teacher-feedback sessions due to time constraints.

  4. Economic evaluation of chronic disease self-management for people with diabetes: a systematic review.

    Science.gov (United States)

    Teljeur, C; Moran, P S; Walshe, S; Smith, S M; Cianci, F; Murphy, L; Harrington, P; Ryan, M

    2017-08-01

    To systematically review the evidence on the costs and cost-effectiveness of self-management support interventions for people with diabetes. Self-management support is the provision of education and supportive interventions to increase patients' skills and confidence in managing their health problems, potentially leading to improvements in HbA 1c levels in people with diabetes. Randomized controlled trials, observational studies or economic modelling studies were eligible for inclusion in the review. The target population was adults with diabetes. Interventions had to have a substantial component of self-management support and be compared with routine care. Study quality was evaluated using the Consensus on Health Economic Criteria and International Society of Pharmacoeconomic Outcomes Research questionnaires. A narrative review approach was used. A total of 16 costing and 21 cost-effectiveness studies of a range of self-management support interventions were identified. There was reasonably consistent evidence across 22 studies evaluating education self-management support programmes suggesting these interventions are cost-effective or superior to usual care. Telemedicine-type interventions were more expensive than usual care and potentially not cost-effective. There was insufficient evidence regarding the other types of self-management interventions, including pharmacist-led and behavioural interventions. The identified studies were predominantly of poor quality, with outcomes based on short-term follow-up data and study designs at high risk of bias. Self-management support education programmes may be cost-effective. There was limited evidence regarding other formats of self-management support interventions. The poor quality of many of the studies undermines the evidence base regarding the economic efficiency of self-management support interventions for people with diabetes. © 2016 Diabetes UK.

  5. Observation chart design features affect the detection of patient deterioration: a systematic experimental evaluation.

    Science.gov (United States)

    Christofidis, Melany J; Hill, Andrew; Horswill, Mark S; Watson, Marcus O

    2016-01-01

    To systematically evaluate the impact of several design features on chart-users' detection of patient deterioration on observation charts with early-warning scoring-systems. Research has shown that observation chart design affects the speed and accuracy with which abnormal observations are detected. However, little is known about the contribution of individual design features to these effects. A 2 × 2 × 2 × 2 mixed factorial design, with data-recording format (drawn dots vs. written numbers), scoring-system integration (integrated colour-based system vs. non-integrated tabular system) and scoring-row placement (grouped vs. separate) varied within-participants and scores (present vs. absent) varied between-participants by random assignment. 205 novice chart-users, tested between March 2011-March 2014, completed 64 trials where they saw real patient data presented on an observation chart. Each participant saw eight cases (four containing abnormal observations) on each of eight designs (which represented a factorial combination of the within-participants variables). On each trial, they assessed whether any of the observations were physiologically abnormal, or whether all observations were normal. Response times and error rates were recorded for each design. Participants responded faster (scores present and absent) and made fewer errors (scores absent) using drawn-dot (vs. written-number) observations and an integrated colour-based (vs. non-integrated tabular) scoring-system. Participants responded faster using grouped (vs. separate) scoring-rows when scores were absent, but separate scoring-rows when scores were present. Our findings suggest that several individual design features can affect novice chart-users' ability to detect patient deterioration. More broadly, the study further demonstrates the need to evaluate chart designs empirically. © 2015 John Wiley & Sons Ltd.

  6. Systematic literature review to evaluate and characterize the health economics and outcomes research studies in India

    Directory of Open Access Journals (Sweden)

    Divya Mishra

    2015-01-01

    Full Text Available Aim: This systematic literature review was conducted to identify, evaluate, and characterize the variety, quality, and intent of the health economics and outcomes research studies being conducted in India. Materials and Methods: Studies published in English language between 1999 and 2012 were retrieved from Embase and PubMed databases using relevant search strategies. Two researchers independently reviewed the studies as per Cochrane methodology; information on the type of research and the outcomes were extracted. Quality of reporting was assessed for model-based health economic studies using a published 100-point Quality of Health Economic Studies (QHES instrument. Results: Of 546 studies screened, 132 were included in the review. The broad study categories were cost-effectiveness analyses [(CEA 54 studies], cost analyses (19 studies, and burden of illness [(BOI 18 studies]. The outcomes evaluated were direct and indirect costs, and incremental cost-effectiveness ratio (ICER, quality-adjusted life years (QALYs, and disability-adjusted life years (DALYs. Direct medical costs assessed cost of medicines, monitoring costs, consultation and hospital charges, along with direct non-medical costs (travel and food for patients and care givers. Loss of productivity and loss of income of patients and care givers were identified as the components of indirect cost. Overall, 33 studies assessed the quality of life (QoL, and the WHO Quality of Life-BREF (WHOQOL-BREF was the most commonly used instrument. Quality assessment for modeling studies showed that most studies were of high quality [mean (range QHES score to be 75.5 (34-93]. Conclusions: This review identified various patterns of pharmacoeconomic studies and good-quality CEA studies. However, there is a need for better assessment of utilization of healthcare resources in India.

  7. A systematic review of adverse event reporting in companion animal clinical trials evaluating cancer treatment.

    Science.gov (United States)

    Giuffrida, Michelle A

    2016-11-01

    OBJECTIVE To evaluate methods used to ascertain, define, and report adverse events (AEs) in companion animal clinical trials involving cancer treatment. DESIGN Systematic review. SAMPLE English-language articles describing prospective clinical trials involving dogs and cats with naturally occurring cancer published in peer-reviewed journals between 2008 and 2014. PROCEDURES Reports were identified via MEDLINE and CAB database searches combined with a hand-searching strategy. General article characteristics were abstracted and summarized. Data for AE reporting were collected with a 14-item checklist adapted from the 2004 CONSORT extension for reporting harms. Study characteristics associated with the AE reporting checklist score were identified by means of linear regression analysis. RESULTS 168 articles with data for 6,132 animals were included. Standardized terminology was significantly more likely to be used to describe AEs for trials that included chemotherapy (92/115 [80.0%]) than for trials that did not (16/53 [30.2%]). Median AE reporting checklist score was 5 out of 14 (range, 0 to 12). Poorly reported items included methods and time frame of AE ascertainment, AE data analysis, and reasons for treatment discontinuation and death. Trials with industry funding, a single-arm design, and treatment with chemotherapy were associated with a significantly higher quality of AE reporting. CONCLUSIONS AND CLINICAL RELEVANCE Reporting of adverse events in veterinary clinical trials evaluating cancer treatment was selective and heterogeneous. Harms associated with cancer treatments could be underestimated because of suboptimal collection and reporting of AE data. Findings supported the adoption of a higher standard for AE surveillance and reporting in veterinary patients.

  8. Economic evaluation of bone stimulation modalities: A systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Button Melissa

    2009-01-01

    Full Text Available Various bone stimulation modalities are commonly used in treatment of fresh fractures and nonunions; however, the effectiveness and efficiency of these modalities remain uncertain. A systematic review of trials evaluating the clinical and economical outcomes of ultrasounds, electrical stimulation, and extracorporeal sound waves on fracture healing was conducted. We searched four electronic databases for economic evaluations that assessed bone stimulation modalities using ultrasound therapy, electrical stimulation, or extracorporeal shock waves. In addition, we searched the references and related articles of eligible studies, and a content expert was contacted. Information on the clinical and economical outcomes of patients was independently extracted by reviewers. Fourteen studies met the inclusion criteria; therefore, very limited research was found on the cost associated with treatments and the corresponding outcomes. The data available focus primarily on the efficacy of newly introduced treatment methods for bone growth, but failed to incorporate the costs of implementing such treatments. One economic analysis was identified that assessed different treatment paths using ultrasound. A total cost savings of 24-40% per patient occurred when ultrasound was used for fresh fractures and nonunions (grade C recommendation. The results suggest that the ultrasound is a viable alternative for bone stimulation; however, the impacts of the other modalities are left unknown due to the lack of research available. Methodological limitations leave the overall economic and clinical impact of these modalities uncertain. Large, prospective, randomized controlled trials that include cost-effectiveness analyses are needed to further define the clinical effectiveness and financial burden associated with bone stimulation modalities.

  9. The International Endometriosis Evaluation Program (IEEP Study) - A Systematic Study for Physicians, Researchers and Patients.

    Science.gov (United States)

    Burghaus, S; Fehm, T; Fasching, P A; Blum, S; Renner, S K; Baier, F; Brodkorb, T; Fahlbusch, C; Findeklee, S; Häberle, L; Heusinger, K; Hildebrandt, T; Lermann, J; Strahl, O; Tchartchian, G; Bojahr, B; Porn, A; Fleisch, M; Reicke, S; Füger, T; Hartung, C-P; Hackl, J; Beckmann, M W; Renner, S P

    2016-08-01

    Endometriosis is a heterogeneous disease characterized by a range of different presentations. It is usually diagnosed when patients present with pain and/or infertility, but it has also been diagnosed in asymptomatic patients. Because of the different diagnostic approaches and diverse therapies, time to diagnosis can vary considerably and the definitive diagnosis may be delayed, with some cases not being diagnosed for several years. Endometriosis patients have many unmet needs. A systematic registration and follow-up of endometriosis patients could be useful to obtain an insight into the course of the disease. The validation of biomarkers could contribute to the development of diagnostic and predictive tests which could help select patients for surgical assessment earlier and offer better predictions about patients who might benefit from medical, surgical or other interventions. The aim is also to obtain a better understanding of the etiology, pathogenesis and progression of the disease. To do this, an online multicenter documentation system was introduced to facilitate the establishment of a prospective multicenter case-control study, the IEEP (International Endometriosis Evaluation Program) study. We report here on the first 696 patients with endometriosis included in the program between June 2013 and June 2015. A documentation system was created, and the structure and course of the study were mapped out with regard to data collection and the collection of biomaterials. The documentation system permits the history and clinical data of patients with endometriosis to be recorded. The IEEP combines this information with biomaterials and uses it for scientific studies. The recorded data can also be used to evaluate clinical quality control measures such as the certification parameters used by the EEL (European Endometriosis League) to assess certified endometriosis centers.

  10. The International Endometriosis Evaluation Program (IEEP Study) – A Systematic Study for Physicians, Researchers and Patients

    Science.gov (United States)

    Burghaus, S.; Fehm, T.; Fasching, P. A.; Blum, S.; Renner, S. K.; Baier, F.; Brodkorb, T.; Fahlbusch, C.; Findeklee, S.; Häberle, L.; Heusinger, K.; Hildebrandt, T.; Lermann, J.; Strahl, O.; Tchartchian, G.; Bojahr, B.; Porn, A.; Fleisch, M.; Reicke, S.; Füger, T.; Hartung, C.-P.; Hackl, J.; Beckmann, M. W.; Renner, S. P.

    2016-01-01

    Introduction: Endometriosis is a heterogeneous disease characterized by a range of different presentations. It is usually diagnosed when patients present with pain and/or infertility, but it has also been diagnosed in asymptomatic patients. Because of the different diagnostic approaches and diverse therapies, time to diagnosis can vary considerably and the definitive diagnosis may be delayed, with some cases not being diagnosed for several years. Endometriosis patients have many unmet needs. A systematic registration and follow-up of endometriosis patients could be useful to obtain an insight into the course of the disease. The validation of biomarkers could contribute to the development of diagnostic and predictive tests which could help select patients for surgical assessment earlier and offer better predictions about patients who might benefit from medical, surgical or other interventions. The aim is also to obtain a better understanding of the etiology, pathogenesis and progression of the disease. Material and Methods: To do this, an online multicenter documentation system was introduced to facilitate the establishment of a prospective multicenter case-control study, the IEEP (International Endometriosis Evaluation Program) study. We report here on the first 696 patients with endometriosis included in the program between June 2013 and June 2015. Results: A documentation system was created, and the structure and course of the study were mapped out with regard to data collection and the collection of biomaterials. Conclusion: The documentation system permits the history and clinical data of patients with endometriosis to be recorded. The IEEP combines this information with biomaterials and uses it for scientific studies. The recorded data can also be used to evaluate clinical quality control measures such as the certification parameters used by the EEL (European Endometriosis League) to assess certified endometriosis centers. PMID:27582581

  11. Neuroscience-related research in Ghana: a systematic evaluation of direction and capacity.

    Science.gov (United States)

    Quansah, Emmanuel; Karikari, Thomas K

    2016-02-01

    Neurological and neuropsychiatric diseases account for considerable healthcare, economic and social burdens in Ghana. In order to effectively address these burdens, appropriately-trained scientists who conduct high-impact neuroscience research will be needed. Additionally, research directions should be aligned with national research priorities. However, to provide information about current neuroscience research productivity and direction, the existing capacity and focus need to be identified. This would allow opportunities for collaborative research and training to be properly explored and developmental interventions to be better targeted. In this study, we sought to evaluate the existing capacity and direction of neuroscience-related research in Ghana. To do this, we examined publications reporting research investigations authored by scientists affiliated with Ghanaian institutions in specific areas of neuroscience over the last two decades (1995-2015). 127 articles that met our inclusion criteria were systematically evaluated in terms of research foci, annual publication trends and author affiliations. The most actively-researched areas identified include neurocognitive impairments in non-nervous system disorders, depression and suicide, epilepsy and seizures, neurological impact of substance misuse, and neurological disorders. These studies were mostly hospital and community-based surveys. About 60% of these articles were published in the last seven years, suggesting a recent increase in research productivity. However, data on experimental and clinical research outcomes were particularly lacking. We suggest that future investigations should focus on the following specific areas where information was lacking: large-scale disease epidemiology, effectiveness of diagnostic platforms and therapeutic treatments, and the genetic, genomic and molecular bases of diseases.

  12. Neglected tropical diseases: a systematic evaluation of research capacity in Nigeria.

    Directory of Open Access Journals (Sweden)

    Patricia N Okorie

    2014-08-01

    Full Text Available Nigeria carries the highest burden and diversity of neglected tropical diseases (NTDs in sub-Saharan Africa and is preparing to scale up its efforts to control/eliminate these diseases. To achieve this it will require a range of internal technical support and expertise for mapping, monitoring and evaluating, operational research and documenting its success. In order to begin to evaluate this potential in Nigeria, this study collated and analysed information for lymphatic filariasis (LF, onchocerciasis, schistosomiasis and soil-transmitted helminths (STH, which are currently being targeted with preventive chemotherapy through mass drug administration (MDA.Information from 299 scientific articles published on the selected NTDs in 179 journals between January 2008 and September 2013 was extracted and systematically compiled into a geo-referenced database for analysis and mapping. The highest number of articles was from the southern geo-political zones of the country. The majority of articles focused on one specific disease, and schistosomiasis and STH were found to have the highest and most wide ranging research output. The main type of study was parasitological, and the least was biotechnological. Nigerian authors were mostly affiliated with universities, and there was a wide range of international co-authors from Africa and other regions, especially the USA and UK. The majority of articles were published in journals with no known impact factor.The extensive database and series of maps on the research capacity within Nigeria produced in this study highlights the current potential that exists, and needs to be fully maximized for the control/elimination of NTDs in the country. This study provides an important model approach that can be applied to other low and middle income countries where NTDs are endemic, and NTD programmes require support from the expertise within their own country, as well as internationally, to help raise their profile and

  13. Systematic evaluation of phantom fluids for simultaneous PET/MR hybrid imaging.

    Science.gov (United States)

    Ziegler, Susanne; Braun, Harald; Ritt, Philipp; Hocke, Carsten; Kuwert, Torsten; Quick, Harald H

    2013-08-01

    With the recent advent of integrated PET/MR hybrid systems, the need for simultaneous PET and MR phantom measurements arises. Phantom fluids that are used in stand-alone MR systems, especially in larger phantoms and at a high magnetic field strength, are not necessarily applicable in PET imaging and vice versa. In this study, different approaches to fluid selection were considered and systematically evaluated with respect to their usability for simultaneous PET/MR phantom imaging. Demineralized water, water with increased electrical conductivity, a water-oil emulsion, and monoethylene and triethylene glycol were investigated in MR and PET measurements using the most common PET tracer (18)F-FDG. As an alternative to (18)F-FDG, a modified PET tracer ((18)F-fluoride Kryptofix 222 complex) was investigated toward its ability to dissolve in pure oil, which provides good signal homogeneity in MR imaging. Measurements were performed on a 3.0 T integrated PET/MR whole-body system using a National Electrical Manufacturers Association quality-standard phantom. All tested fluids dissolved the radiotracer (18)F-FDG homogeneously. Regarding their suitability for MR at 3.0 T, all fluids significantly improved the homogeneity compared to pure water (increase of excitation flip angle within the tested phantom by a factor of 2.0). When the use of (18)F-FDG was preferred, triethylene glycol provided the best compromise (flip angle increase by a factor of 1.13). The potential alternative tracer, (18)F-fluoride Kryptofix 222 complex, dissolved in pure oil; however, it is not optimal in its tested composition because it accumulates at the bottom of the phantom during the time of measurement. This study provides a systematic approach toward phantom fluid selection for imaging a given quality-standard body phantom--and phantoms of comparable size--at 3.0 T. For simultaneous PET/MR scans using the standard tracer (18)F-FDG, an alternative fluid to water and oil is proposed that serves as

  14. Protocol: a systematic review of studies developing and/or evaluating search strategies to identify prognosis studies.

    Science.gov (United States)

    Corp, Nadia; Jordan, Joanne L; Hayden, Jill A; Irvin, Emma; Parker, Robin; Smith, Andrea; van der Windt, Danielle A

    2017-04-20

    Prognosis research is on the rise, its importance recognised because chronic health conditions and diseases are increasingly common and costly. Prognosis systematic reviews are needed to collate and synthesise these research findings, especially to help inform effective clinical decision-making and healthcare policy. A detailed, comprehensive search strategy is central to any systematic review. However, within prognosis research, this is challenging due to poor reporting and inconsistent use of available indexing terms in electronic databases. Whilst many published search filters exist for finding clinical trials, this is not the case for prognosis studies. This systematic review aims to identify and compare existing methodological filters developed and evaluated to identify prognosis studies of any of the three main types: overall prognosis, prognostic factors, and prognostic [risk prediction] models. Primary studies reporting the development and/or evaluation of methodological search filters to retrieve any type of prognosis study will be included in this systematic review. Multiple electronic bibliographic databases will be searched, grey literature will be sought from relevant organisations and websites, experts will be contacted, and citation tracking of key papers and reference list checking of all included papers will be undertaken. Titles will be screened by one person, and abstracts and full articles will be reviewed for inclusion independently by two reviewers. Data extraction and quality assessment will also be undertaken independently by two reviewers with disagreements resolved by discussion or by a third reviewer if necessary. Filters' characteristics and performance metrics reported in the included studies will be extracted and tabulated. To enable comparisons, filters will be grouped according to database, platform, type of prognosis study, and type of filter for which it was intended. This systematic review will identify all existing validated

  15. Quantification of the Barkhausen noise method for the evaluation of time-dependent degradation

    Science.gov (United States)

    Kim, Dong-Won; Kwon, Dongil

    2003-02-01

    The Barkhausen noise (BN) method has long been applied to measure the bulk magnetic properties of magnetic materials. Recently, this important nondestructive testing (NDT) method has been applied to evaluate microstructure, stress distribution analysis, fatigue, creep and fracture characteristics. Until now the BN method has been used only qualitatively in evaluating the variation of BN with variations in material properties. For this reason, few NDT methods have been applied in industrial plants and laboratories. The present investigation studied the coercive force and BN while varying the microstructure of ultrafine-grained steels and SA508 cl.3 steels. This variation was carried out according to the second heat-treatment condition with rolling of ultrafine-grained steels and the simulated time-dependent degradation of SA 508 cl.3 steels. An attempt was also made to quantify BN from the relationship between the velocity of magnetic domain walls and the retarding force, using the coercive force of the domain wall movement. The microstructure variation was analyzed according to time-dependent degradation. Fracture toughness was evaluated quantitatively by measuring the BN from two intermediary parameters; grain size and distribution of nonmagnetic particles. From these measurements, the variation of microstructure and fracture toughness can be directly evaluated by the BN method as an accurate in situ NDT method.

  16. White LED compared with other light sources: age-dependent photobiological effects and parameters for evaluation.

    Science.gov (United States)

    Rebec, Katja Malovrh; Klanjšek-Gunde, Marta; Bizjak, Grega; Kobav, Matej B

    2015-01-01

    Ergonomic science at work and living places should appraise human factors concerning the photobiological effects of lighting. Thorough knowledge on this subject has been gained in the past; however, few attempts have been made to propose suitable evaluation parameters. The blue light hazard and its influence on melatonin secretion in age-dependent observers is considered in this paper and parameters for its evaluation are proposed. New parameters were applied to analyse the effects of white light-emitting diode (LED) light sources and to compare them with the currently applied light sources. The photobiological effects of light sources with the same illuminance but different spectral power distribution were determined for healthy 4-76-year-old observers. The suitability of new parameters is discussed. Correlated colour temperature, the only parameter currently used to assess photobiological effects, is evaluated and compared to new parameters.

  17. Evaluation of NAD(+) -dependent DNA ligase of mycobacteria as a potential target for antibiotics.

    Science.gov (United States)

    Korycka-Machala, Malgorzata; Rychta, Ewelina; Brzostek, Anna; Sayer, Heather R; Rumijowska-Galewicz, Anna; Bowater, Richard P; Dziadek, Jarosław

    2007-08-01

    Mycobacteria contain genes for several DNA ligases, including ligA, which encodes a NAD(+)-dependent enzyme that has been postulated to be a target for novel antibacterial compounds. Using a homologous recombination system, direct evidence is presented that wild-type ligA cannot be deleted from the chromosome of Mycobacterium smegmatis. Deletions of native ligA in M. smegmatis could be obtained only after the integration of an extra copy of M. smegmatis or Mycobacterium tuberculosis ligA into the attB site of the chromosome, with expression controlled by chemically inducible promoters. The four ATP-dependent DNA ligases encoded by the M. smegmatis chromosome were unable to replace the function of LigA. Interestingly, the LigA protein from M. smegmatis could be substituted with the NAD(+)-dependent DNA ligase of Escherichia coli or the ATP-dependent ligase of bacteriophage T4. The conditional mutant strains allowed the analysis of the effect of LigA depletion on the growth of M. smegmatis. The protein level of the conditional mutants was estimated by Western blot analysis using antibodies raised against LigA of M. tuberculosis. This revealed that a strong overproduction or depletion of LigA did not affect the growth or survival of mycobacteria under standard laboratory conditions. In conclusion, although NAD(+)-dependent DNA ligase is essential for mycobacterial viability, only low levels of protein are required for growth. These findings suggest that very efficient inhibition of enzyme activity would be required if NAD(+)-dependent DNA ligase is to be useful as an antibiotic target in mycobacteria. The strains developed here will provide useful tools for the evaluation of the efficacy of any appropriate compounds in mycobacteria.

  18. Evaluation of Quality of Life instruments for use in COPD care and research: a systematic review.

    Science.gov (United States)

    Weldam, Saskia W M; Schuurmans, Marieke J; Liu, Rani; Lammers, Jan-Willem J

    2013-05-01

    Quality of Life (QoL) measurements to quantify disease burden have become an important outcome measure in Chronic Obstructive Pulmonary Disease (COPD) research and treatment. A large variety of QoL instruments is available. The objective of this review was to comprehensively evaluate content and psychometric properties of available QoL instruments used in COPD care and research. A systematic literature search was performed. The databases PubMed, Embase, CINAHL, and the Cochrane Library were used. Two researchers independently identified eligible studies. Methodological quality of the studies and data on measurement properties were assessed by using the Consensus based Standards for selection of health Measurement Instruments (COSMIN). A best evidence synthesis for each instrument was performed. 77 studies describing 13 disease-specific and 10 generic QoL instruments were identified. The content of the instruments showed a great variety. 20 instruments measured mobility. Pulmonary symptoms were measured in 11 disease specific instruments. Pain, vitality, and spiritual activities were domains seen only in generic instruments. Social and emotional functioning were domains seen in disease specific instruments as well as in generic instruments. The methodological quality of the studies was mostly rated fair, according to the COSMIN checklist. The psychometric properties of the instruments (validity, reliability and responsiveness) were in general rated positive. The best evidence synthesis showed the strongest positive evidence for the disease specific instruments Chronic Respiratory Questionnaire (CRQ), COPD Assessment Test (CAT), Saint George Respiratory Questionnaire (SGRQ), and Living with COPD questionnaire (LCOPD). The generic instruments received less favorable ratings. Despite the comprehensive overview we could not uniformly recommend the best instrument to evaluate QoL in COPD patients. However, we could recommend the disease specific instruments CRQ, CAT

  19. [Secondary hypothyroidism after cervical irradiation: systematic evaluation of thyroid function in follow-up].

    Science.gov (United States)

    Gonçalves, Sara Monteiro; Ferreira, Brígida Costa; Guardado, Maria João; Marques, Rui; Serra, Tânia; Serra, Maria João; Roda, Domingos; Brandão, Joana; Melo, Gilberto; Lopes, Maria Carmo; Khouri, Leila

    2014-01-01

    complication after irradiation and affects a large percentage of patients undergoing cervical radiotherapy with curative intent. It has been shown that the risk of hypothyroidism increases with time after exposure, but the highest incidence appears to be in the first two years after treatment. From our analysis we obtained at 12 months, a rate of incidence of hypothyroidism of 18.6% (16.55% grade 1 and grade 2, 2.1%). This study found an incidence of hypothyroidism corresponding to the lowest values reported in other published studies. The short duration of follow-up considered in this analysis, may justify these results. With these results and their correlation with the available literature, the authors consider justified and recommend the inclusion of the systematic evaluation of thyroid function in the follow-up protocol of these patients.

  20. An Experimental Technique for the Evaluation of Strain Dependent Material Properties of Hard Coatings

    Directory of Open Access Journals (Sweden)

    Shad A. Reed

    2008-01-01

    Full Text Available A novel vibration experiment consisting of a free-free boundary condition, an electromagnetic excitation source, a vacuum chamber, and a laser vibrometer based surface measurement system has been developed that permits high levels of excitation on highly damped specimens with a minimal amount of unwanted systematic error. While some of the aspects of this experiment are not unique, when combined with a processing technique that accounts for the nonlinearities present in the system, this experiment permits, accurate measurement of strain dependent stiffness and damping properties of hard coatings at high strain levels. This procedure has been demonstrated using a titanium beam that has been coated with a free-layer damping treatment of Magnesium Aluminate Spinel. The results indicate that Magnesium Aluminate Spinel has both nonlinear stiffness and damping properties. The stiffness asymptotes to a minimum value around 650 microstrain while the damping is a maximum around 100 microstrain. Additionally, the data contained herein cover a larger strain range for this material than previously reported.

  1. Influence of time-dependent factors in the evaluation of critical infrastructure protection measures.

    Energy Technology Data Exchange (ETDEWEB)

    Buehring, W. A.; Samsa, M. E.; Decision and Information Sciences

    2008-03-28

    The examination of which protective measures are the most appropriate to be implemented in order to prevent, protect against, respond to, and recover from attacks on critical infrastructures and key resources typically involves a comparison of the consequences that could occur when the protective measure is implemented to those that could occur when it is not. This report describes a framework for evaluation that provides some additional capabilities for comparing optional protective measures. It illustrates some potentially important time-dependent factors, such as the implementation rate, that affect the relative pros and cons associated with widespread implementation of protective measures. It presents example results from the use of protective measures, such as detectors and pretrained responders, for an illustrative biological incident. Results show that the choice of an alternative measure can depend on whether or not policy and financial support can be maintained for extended periods of time. Choice of a time horizon greatly influences the comparison of alternatives.

  2. Evaluating the scientific basis of quality indicators in colorectal cancer care: A systematic review.

    Science.gov (United States)

    Keikes, Lotte; Koopman, Miriam; Tanis, Pieter J; Lemmens, Valery E P P; Punt, Cornelis J A; van Oijen, Martijn G H

    2017-11-01

    In colorectal cancer care, many indicators for assessment and improvement of quality of care are being used. These quality indicators serve as national and international benchmarks to compare health care on hospital and patient level. However, the scientific basis of these indicators is often unclear. Therefore, the aim of this systematic review is to examine reported quality indicators used in multidisciplinary colorectal cancer care and categorise these indicators based on scientific evidence. We searched PubMed from 2005 to 2015 for original articles reporting on development, evaluation or validation of quality indicators in colorectal cancer care. Included articles were categorised in consensus-based, evidence-based and validation cohort studies. Extracted quality indicators were divided into structure, process and outcome indicators and grouped per discipline(s) involved. From 1163 studies, 41 articles were included: 12 (29%) consensus-based, 7 (17%) evidence-based and 22 (54%) validation cohort studies. In total, we identified 389 reported quality indicators: consensus-based (n = 349), evidence-based (n = 7) and validation (n = 33), respectively. Of all reported indicators, 45% (n = 186) concerned surgical items. The vast majority were process indicators (n = 315; 81%) and the remaining outcome (n = 57; 15%) or structure measurements (n = 17; 4%). Only 5 indicators were reported in the majority (≥7/12 articles) of consensus-based papers and 7 indicators were successfully validated. There is an abundance of reported colorectal cancer quality indicators, of which the majority are surgical, consensus-based process measures, which have not been validated in cohort studies. There is a need for international consensus on a limited evidence-based data set of validated quality indicators, with a focus on outcome indicators. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Quantifying Overdiagnosis in Cancer Screening: A Systematic Review to Evaluate the Methodology.

    Science.gov (United States)

    Ripping, Theodora M; Ten Haaf, Kevin; Verbeek, André L M; van Ravesteyn, Nicolien T; Broeders, Mireille J M

    2017-10-01

    Overdiagnosis is the main harm of cancer screening programs but is difficult to quantify. This review aims to evaluate existing approaches to estimate the magnitude of overdiagnosis in cancer screening in order to gain insight into the strengths and limitations of these approaches and to provide researchers with guidance to obtain reliable estimates of overdiagnosis in cancer screening. A systematic review was done of primary research studies in PubMed that were published before January 1, 2016, and quantified overdiagnosis in breast cancer screening. The studies meeting inclusion criteria were then categorized by their methods to adjust for lead time and to obtain an unscreened reference population. For each approach, we provide an overview of the data required, assumptions made, limitations, and strengths. A total of 442 studies were identified in the initial search. Forty studies met the inclusion criteria for the qualitative review. We grouped the approaches to adjust for lead time in two main categories: the lead time approach and the excess incidence approach. The lead time approach was further subdivided into the mean lead time approach, lead time distribution approach, and natural history modeling. The excess incidence approach was subdivided into the cumulative incidence approach and early vs late-stage cancer approach. The approaches used to obtain an unscreened reference population were grouped into the following categories: control group of a randomized controlled trial, nonattenders, control region, extrapolation of a prescreening trend, uninvited groups, adjustment for the effect of screening, and natural history modeling. Each approach to adjust for lead time and obtain an unscreened reference population has its own strengths and limitations, which should be taken into consideration when estimating overdiagnosis.

  4. Measurement, Classification and Evaluation of Sleep Disturbance in Psoriasis: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Alasdair L Henry

    Full Text Available Psoriasis is a long-term immune-mediated inflammatory disorder mainly, but not only, affecting skin, and is associated with significant medical and psychological morbidity. Evidence suggests that sleep is disrupted in psoriasis, however high quality empirical evidence is lacking. Given the importance of sleep for health, characterisation of sleep disruption in psoriasis is an important goal. We therefore conducted a systematic review of the sleep-psoriasis literature.Searches were conducted in Pubmed, SCOPUS and Web of Science from inception to May 2016. Studies were compared against inclusion/exclusion criteria and underwent a quality evaluation. Given the heterogeneity of studies, we conducted a narrative synthesis of the findings.Searches revealed 32 studies which met our predetermined inclusion/exclusion criteria. Whilst 93.7% of studies reported sleep disruption in this population, ranging from 0.05% to 85.4%, many had important methodological shortcomings. Over half of all quantitative studies (54.8%; 17/31 relied on non-validated measures, contributing to heterogeneity in study findings. In those that employed valid measures, assessing sleep was often not the primary objective. We frequently found the absence of adequate sample size calculations and poor statistical reporting.This review showed that in psoriasis, reported sleep rates of sleep disturbance varied substantially. Most studies lacked a hypothesis driven research question and/or failed to use validated measures of sleep. We were unable to draw firm conclusions about the precise prevalence and nature of sleep disturbance within the psoriasis population. We offer suggestions to help advance understanding of sleep disturbance in psoriasis.

  5. Measurement, Classification and Evaluation of Sleep Disturbance in Psoriasis: A Systematic Review.

    Science.gov (United States)

    Henry, Alasdair L; Kyle, Simon D; Bhandari, Sahil; Chisholm, Anna; Griffiths, Christopher E M; Bundy, Christine

    2016-01-01

    Psoriasis is a long-term immune-mediated inflammatory disorder mainly, but not only, affecting skin, and is associated with significant medical and psychological morbidity. Evidence suggests that sleep is disrupted in psoriasis, however high quality empirical evidence is lacking. Given the importance of sleep for health, characterisation of sleep disruption in psoriasis is an important goal. We therefore conducted a systematic review of the sleep-psoriasis literature. Searches were conducted in Pubmed, SCOPUS and Web of Science from inception to May 2016. Studies were compared against inclusion/exclusion criteria and underwent a quality evaluation. Given the heterogeneity of studies, we conducted a narrative synthesis of the findings. Searches revealed 32 studies which met our predetermined inclusion/exclusion criteria. Whilst 93.7% of studies reported sleep disruption in this population, ranging from 0.05% to 85.4%, many had important methodological shortcomings. Over half of all quantitative studies (54.8%; 17/31) relied on non-validated measures, contributing to heterogeneity in study findings. In those that employed valid measures, assessing sleep was often not the primary objective. We frequently found the absence of adequate sample size calculations and poor statistical reporting. This review showed that in psoriasis, reported sleep rates of sleep disturbance varied substantially. Most studies lacked a hypothesis driven research question and/or failed to use validated measures of sleep. We were unable to draw firm conclusions about the precise prevalence and nature of sleep disturbance within the psoriasis population. We offer suggestions to help advance understanding of sleep disturbance in psoriasis.

  6. Impact of immunization technology and assay application on antibody performance--a systematic comparative evaluation.

    Directory of Open Access Journals (Sweden)

    Michael C Brown

    Full Text Available Antibodies are quintessential affinity reagents for the investigation and determination of a protein's expression patterns, localization, quantitation, modifications, purification, and functional understanding. Antibodies are typically used in techniques such as Western blot, immunohistochemistry (IHC, and enzyme-linked immunosorbent assays (ELISA, among others. The methods employed to generate antibodies can have a profound impact on their success in any of these applications. We raised antibodies against 10 serum proteins using 3 immunization methods: peptide antigens (3 per protein, DNA prime/protein fragment-boost ("DNA immunization"; 3 per protein, and full length protein. Antibodies thus generated were systematically evaluated using several different assay technologies (ELISA, IHC, and Western blot. Antibodies raised against peptides worked predominantly in applications where the target protein was denatured (57% success in Western blot, 66% success in immunohistochemistry, although 37% of the antibodies thus generated did not work in any of these applications. In contrast, antibodies produced by DNA immunization performed well against both denatured and native targets with a high level of success: 93% success in Western blots, 100% success in immunohistochemistry, and 79% success in ELISA. Importantly, success in one assay method was not predictive of success in another. Immunization with full length protein consistently yielded the best results; however, this method is not typically available for new targets, due to the difficulty of generating full length protein. We conclude that DNA immunization strategies which are not encumbered by the limitations of efficacy (peptides or requirements for full length proteins can be quite successful, particularly when multiple constructs for each protein are used.

  7. Embodied simulation as part of affective evaluation processes: task dependence of valence concordant EMG activity.

    Science.gov (United States)

    Weinreich, André; Funcke, Jakob Maria

    2014-01-01

    Drawing on recent findings, this study examines whether valence concordant electromyography (EMG) responses can be explained as an unconditional effect of mere stimulus processing or as somatosensory simulation driven by task-dependent processing strategies. While facial EMG over the Corrugator supercilii and the Zygomaticus major was measured, each participant performed two tasks with pictures of album covers. One task was an affective evaluation task and the other was to attribute the album covers to one of five decades. The Embodied Emotion Account predicts that valence concordant EMG is more likely to occur if the task necessitates a somatosensory simulation of the evaluative meaning of stimuli. Results support this prediction with regard to Corrugator supercilii in that valence concordant EMG activity was only present in the affective evaluation task but not in the non-evaluative task. Results for the Zygomaticus major were ambiguous. Our findings are in line with the view that EMG activity is an embodied part of the evaluation process and not a mere physical outcome.

  8. An evaluation of systematic tuberculosis screening at private facilities in Karachi, Pakistan.

    Directory of Open Access Journals (Sweden)

    Jacob Creswell

    Full Text Available BACKGROUND: In Pakistan, like many Asian countries, a large proportion of healthcare is provided through the private sector. We evaluated a systematic screening strategy to identify people with tuberculosis in private facilities in Karachi and assessed the approaches' ability to diagnose patients earlier in their disease progression. METHODS AND FINDINGS: Lay workers at 89 private clinics and a large hospital outpatient department screened all attendees for tuberculosis using a mobile phone-based questionnaire during one year. The number needed to screen to detect a case of tuberculosis was calculated. To evaluate early diagnosis, we tested for differences in cough duration and smear grading by screening facility. 529,447 people were screened, 1,010 smear-positive tuberculosis cases were detected and 942 (93.3% started treatment, representing 58.7% of all smear-positive cases notified in the intervention area. The number needed to screen to detect a smear-positive case was 124 (prevalence 806/100,000 at the hospital and 763 (prevalence 131/100,000 at the clinics; however, ten times the number of individuals were screened in clinics. People with smear-positive TB detected at the hospital were less likely to report cough lasting 2-3 weeks (RR 0.66 95%CI [0.49-0.90] and more likely to report cough duration >3 weeks (RR 1.10 95%CI [1.03-1.18]. Smear-positive cases at the clinics were less likely to have a +3 grade (RR 0.76 95%CI [0.63-0.92] and more likely to have +1 smear grade (RR 1.24 95%CI [1.02-1.51]. CONCLUSIONS: Tuberculosis screening at private facilities is acceptable and can yield large numbers of previously undiagnosed cases. Screening at general practitioner clinics may find cases earlier than at hospitals although more people must be screened to identify a case of tuberculosis. Limitations include lack of culture testing, therefore underestimating true TB prevalence. Using more sensitive and specific screening and diagnostic tests such

  9. An evaluation of systematic tuberculosis screening at private facilities in Karachi, Pakistan.

    Science.gov (United States)

    Creswell, Jacob; Khowaja, Saira; Codlin, Andrew; Hashmi, Rabia; Rasheed, Erum; Khan, Mubashir; Durab, Irfan; Mergenthaler, Christina; Hussain, Owais; Khan, Faisal; Khan, Aamir J

    2014-01-01

    In Pakistan, like many Asian countries, a large proportion of healthcare is provided through the private sector. We evaluated a systematic screening strategy to identify people with tuberculosis in private facilities in Karachi and assessed the approaches' ability to diagnose patients earlier in their disease progression. Lay workers at 89 private clinics and a large hospital outpatient department screened all attendees for tuberculosis using a mobile phone-based questionnaire during one year. The number needed to screen to detect a case of tuberculosis was calculated. To evaluate early diagnosis, we tested for differences in cough duration and smear grading by screening facility. 529,447 people were screened, 1,010 smear-positive tuberculosis cases were detected and 942 (93.3%) started treatment, representing 58.7% of all smear-positive cases notified in the intervention area. The number needed to screen to detect a smear-positive case was 124 (prevalence 806/100,000) at the hospital and 763 (prevalence 131/100,000) at the clinics; however, ten times the number of individuals were screened in clinics. People with smear-positive TB detected at the hospital were less likely to report cough lasting 2-3 weeks (RR 0.66 95%CI [0.49-0.90]) and more likely to report cough duration >3 weeks (RR 1.10 95%CI [1.03-1.18]). Smear-positive cases at the clinics were less likely to have a +3 grade (RR 0.76 95%CI [0.63-0.92]) and more likely to have +1 smear grade (RR 1.24 95%CI [1.02-1.51]). Tuberculosis screening at private facilities is acceptable and can yield large numbers of previously undiagnosed cases. Screening at general practitioner clinics may find cases earlier than at hospitals although more people must be screened to identify a case of tuberculosis. Limitations include lack of culture testing, therefore underestimating true TB prevalence. Using more sensitive and specific screening and diagnostic tests such as chest x-ray and Xpert MTB/RIF may improve results.

  10. Health-related quality of life in alcohol dependence: a systematic literature review with a specific focus on the role of depression and other psychopathology.

    Science.gov (United States)

    Levola, Jonna; Aalto, Mauri; Holopainen, Antti; Cieza, Alarcos; Pitkänen, Tuuli

    2014-08-01

    Health-related quality of life (HRQOL) is considered a valid measure of treatment effectiveness in addictions. However, alcohol research has lagged behind other biomedical fields in using HRQOL outcomes as primary or secondary endpoints. Previous work has suggested that psychiatric co-morbidity may mediate the relationship between alcohol dependence and HRQOL. The goal was to summarize the literature on HRQOL and its domains in the context of alcohol dependence. A specific focus was on the impact of depression and other psychopathology on these areas of life. A database search of MEDLINE and PsychINFO was performed within the scope of PARADISE (Psychosocial fActors Relevant to brAin DISorders in Europe); a European Commission funded coordination action. Using pre-defined eligibility criteria, 42 studies were identified. A systematic approach to data collection was employed. Alcohol dependence was shown to affect overall HRQOL and its domains, including general health, physical and mental health, general and social functioning, activities of daily living, pain and sleep. The evidence demonstrating that alcohol dependence is a primary cause of impairments in overall HRQOL, general health, mental and physical health and social functioning was fairly strong. Treatment interventions helped improve HRQOL and its aforementioned domains. The reduction or cessation of alcohol use facilitated these improvements; however, it was not reported to be predictive of improvement in all instances where improvement was reported. Depression was associated with further decreases in HRQOL. Personality disorders contributed to the severity of social functioning impairment.

  11. A Systematic Analysis of Factors Localized to Damaged Chromatin Reveals PARP-Dependent Recruitment of Transcription Factors

    Directory of Open Access Journals (Sweden)

    Lior Izhar

    2015-06-01

    Full Text Available Localization to sites of DNA damage is a hallmark of DNA damage response (DDR proteins. To identify DDR factors, we screened epitope-tagged proteins for localization to sites of chromatin damaged by UV laser microirradiation and found >120 proteins that localize to damaged chromatin. These include the BAF tumor suppressor complex and the amyotrophic lateral sclerosis (ALS candidate protein TAF15. TAF15 contains multiple domains that bind damaged chromatin in a poly-(ADP-ribose polymerase (PARP-dependent manner, suggesting a possible role as glue that tethers multiple PAR chains together. Many positives were transcription factors; > 70% of randomly tested transcription factors localized to sites of DNA damage, and of these, ∼90% were PARP dependent for localization. Mutational analyses showed that localization to damaged chromatin is DNA-binding-domain dependent. By examining Hoechst staining patterns at damage sites, we see evidence of chromatin decompaction that is PARP dependent. We propose that PARP-regulated chromatin remodeling at sites of damage allows transient accessibility of DNA-binding proteins.

  12. A systematic evaluation of microRNAs in regulating human hepatic CYP2E1

    Science.gov (United States)

    Wang, Yong; Yu, Dianke; Tolleson, William H.; Yu, Li-Rong; Green, Bridgett; Zeng, Linjuan; Chen, Yinting; Chen, Si; Ren, Zhen; Guo, Lei; Tong, Weida; Guan, Huaijin; Ning, Baitang

    2017-01-01

    Cytochrome P450 2E1 (CYP2E1) is an important drug metabolizing enzyme for processing numerous xenobiotics in the liver, including acetaminophen and ethanol. Previous studies have shown that microRNAs (miRNAs) can suppress CYP2E1 expression by binding to the 3′-untranslated region (3′-UTR) of its transcript. However, a systematic analysis of CYP2E1 regulation by miRNAs has not been described. Here, we applied in silico, in vivo, and in vitro approaches to investigate miRNAs involved in the regulation of CYP2E1. Initially, potential miRNA binding sites in the CYP2E1 mRNA transcript were identified and screened using in silico methods. Next, inverse correlations were found in human liver samples between the expression of CYP2E1 mRNA and the levels of two miRNA species, hsa-miR-214-3p and hsa-miR-942-5p. In a HepG2-derived CYP2E1 over-expression cell model, hsa-miR-214-3p exhibited strong suppression of CYP2E1 expression by targeting the coding region of its mRNA transcript, but hsa-miR-942-5p did not inhibit CYP2E1 levels. Electrophoretic mobility shift assays confirmed that hsa-miR-214-3p recruited other cellular protein factors to form stable complexes with specific sequences present in the CYP2E1 mRNA open reading frame. Transfection of HepaRG cells with hsa-miR-214-3p mimics inhibited expression of the endogenous CYP2E1 gene. Further, hsa-miR-214-3p mimics partially blocked ethanol-dependent increases in CYP2E1 mRNA and protein levels in HepG2 cells and they reduced the release of alanine aminotransferase from CYP2E1-overexpressing HepG2 cells exposed to acetaminophen. These results substantiate the suppressing effect of hsa-miR-214-3p on CYP2E1 expression. PMID:28438567

  13. Evaluation of patient involvement in a systematic review and meta-analysis of individual patient data in cervical cancer treatment

    Directory of Open Access Journals (Sweden)

    Vale Claire L

    2012-05-01

    Full Text Available Abstract Background In April 2005, researchers based at the Medical Research Council Clinical Trials Unit, set out to involve women affected by cervical cancer in a systematic review and meta-analysis of individual patient data to evaluate treatments for this disease. Each of the women had previously been treated for cervical cancer. Following completion of the meta-analysis, we aimed to evaluate the process of involvement from the researcher and research partner perspective. Methods An advisory group was first established to give advice on recruiting, supporting and involving women and led to efforts to recruit women to take part in the systematic review using different approaches. Evaluation of the process and outcomes of the partnership between the systematic reviewers and the patients, in respect to what the partnership achieved; what worked well and what were the difficulties; what was learned and the resource requirements, took place during the conduct of the meta-analysis and again after completion of the project. Results Six women, each of whom had received treatments for cervical cancer, were recruited as Patient Research Partners and five of these women subsequently took part in a variety of activities around the systematic review. They attended progress meetings and all but one attended a meeting at which the first results of the review were presented to all collaborators and gave feedback. Three of the women also became involved in a further related research project which led to an editorial publication from the patient perspective and also participated, along with two lead researchers, in the evaluation of the process and outcomes. While they were generally positive about the experience, one Patient Research Partner questioned the extent of the impact patients could make to the systematic review process. Conclusions In general, researchers and patient research partners felt that they had learned a lot from the process and considered

  14. How you evaluate treatment results in low back pain patients depends on who the patient is

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein

    2008-01-01

    How you evaluate treatment results in low back pain patients depends on who the patient is Lauridsen, HH 1*, Hartvigsen, J1,2, Manniche, C1,3, Korsholm, L1,4, Grunnet-Nilsson, N1 1.    Clinical Locomotion Science, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark...... pain subscales of the SF36, the Low Back Pain Rating Scale (LBPRS) and a numerical rating scale for pain (0-10) were completed by 191 patients from the primary and secondary sectors of the Danish health care system. Clinical change was estimated using a 7-point transition question and a numeric rating...... of an evaluative instrument in back pain patients is complicated because of lack of head-to-head comparisons of clinimetric properties of the various instruments. In addition, little is known about instrument behaviour in clinical subgroups. The objective of this study was to concurrently compare responsiveness...

  15. Systematic literature reviews and meta-analyses: part 6 of a series on evaluation of scientific publications.

    Science.gov (United States)

    Ressing, Meike; Blettner, Maria; Klug, Stefanie J

    2009-07-01

    Because of the rising number of scientific publications, it is important to have a means of jointly summarizing and assessing different studies on a single topic. Systematic literature reviews, meta-analyses of published data, and meta-analyses of individual data (pooled reanalyses) are now being published with increasing frequency. We here describe the essential features of these methods and discuss their strengths and weaknesses. This article is based on a selective literature search. The different types of review and meta-analysis are described, the methods used in each are outlined so that they can be evaluated, and a checklist is given for the assessment of reviews and meta-analyses of scientific articles. Systematic literature reviews provide an overview of the state of research on a given topic and enable an assessment of the quality of individual studies. They also allow the results of different studies to be evaluated together when these are inconsistent. Meta-analyses additionally allow calculation of pooled estimates of an effect. The different types of review and meta-analysis are discussed with examples from the literature on one particular topic. Systematic literature reviews and meta-analyses enable the research findings and treatment effects obtained in different individual studies to be summed up and evaluated.

  16. Antipsychotics for cocaine or psychostimulant dependence: systematic review and meta-analysis of randomized, placebo-controlled trials.

    Science.gov (United States)

    Kishi, Taro; Matsuda, Yuki; Iwata, Nakao; Correll, Christoph U

    2013-12-01

    Since cocaine and psychostimulant dependence are related to increased dopamine release, antipsychotics have been tried to reduce their reinforcing properties. A meta-analysis was undertaken to assess the efficacy and tolerability of antipsychotics in cocaine- or stimulant-dependent patients. We searched PubMed, Cochrane Library databases, and PsycINFO from database inception until June 24, 2013, using the following keywords: (randomized OR random OR randomly) AND (placebo) AND (methylphenidate OR cocaine OR methamphetamine OR amphetamine OR 3,4-methylenedioxymethamphetamine) AND (dependence OR abuse) AND (antipsychotic OR neuroleptic OR 34 specific antipsychotic names). Included were randomized, placebo-controlled trials of antipsychotics lasting at least 2 weeks in patients with primary cocaine or psychostimulant dependence. Of 363 hits, we removed 316 duplicates, 20 references based on abstract/title, and 13 ineligible full-text articles, retaining 14 trials for this meta-analysis. Two authors independently extracted the data. Coprimary outcomes included degree of substance use and lack of abstinence. Risk ratio (RR), 95% CI, and standardized mean difference were calculated. Ten studies in patients with primary cocaine dependence (risperidone = 5, olanzapine = 3, reserpine = 2; n = 562) and 4 in those with amphetamine/methamphetamine dependence (aripiprazole = 4; n = 179) were meta-analyzed (14 studies, total n = 741). When study results were pooled together, antipsychotics did not differ from placebo in regard to cocaine use days and lack of cocaine or amphetamine/methamphetamine abstinence, severity of addiction, cocaine or amphetamine/methamphetamine craving, Clinical Global Impressions-Severity of Illness (CGI-S) scores, depression, anxiety, compliance, all-cause discontinuation, and several side effects. However, antipsychotics caused more intolerability-related discontinuation than placebo (P = .0009). Individually, aripiprazole was superior to placebo in

  17. Faster title and abstract screening? Evaluating Abstrackr, a semi-automated online screening program for systematic reviewers.

    Science.gov (United States)

    Rathbone, John; Hoffmann, Tammy; Glasziou, Paul

    2015-06-15

    Citation screening is time consuming and inefficient. We sought to evaluate the performance of Abstrackr, a semi-automated online tool for predictive title and abstract screening. Four systematic reviews (aHUS, dietary fibre, ECHO, rituximab) were used to evaluate Abstrackr. Citations from electronic searches of biomedical databases were imported into Abstrackr, and titles and abstracts were screened and included or excluded according to the entry criteria. This process was continued until Abstrackr predicted and classified the remaining unscreened citations as relevant or irrelevant. These classification predictions were checked for accuracy against the original review decisions. Sensitivity analyses were performed to assess the effects of including case reports in the aHUS dataset whilst screening and the effects of using larger imbalanced datasets with the ECHO dataset. The performance of Abstrackr was calculated according to the number of relevant studies missed, the workload saving, the false negative rate, and the precision of the algorithm to correctly predict relevant studies for inclusion, i.e. further full text inspection. Of the unscreened citations, Abstrackr's prediction algorithm correctly identified all relevant citations for the rituximab and dietary fibre reviews. However, one relevant citation in both the aHUS and ECHO reviews was incorrectly predicted as not relevant. The workload saving achieved with Abstrackr varied depending on the complexity and size of the reviews (9 % rituximab, 40 % dietary fibre, 67 % aHUS, and 57 % ECHO). The proportion of citations predicted as relevant, and therefore, warranting further full text inspection (i.e. the precision of the prediction) ranged from 16 % (aHUS) to 45 % (rituximab) and was affected by the complexity of the reviews. The false negative rate ranged from 2.4 to 21.7 %. Sensitivity analysis performed on the aHUS dataset increased the precision from 16 to 25 % and increased the workload saving by 10

  18. R-IDEAL: A Framework for Systematic Clinical Evaluation of Technical Innovations in Radiation Oncology.

    Science.gov (United States)

    Verkooijen, Helena M; Kerkmeijer, Linda G W; Fuller, Clifton D; Huddart, Robbert; Faivre-Finn, Corinne; Verheij, Marcel; Mook, Stella; Sahgal, Arjun; Hall, Emma; Schultz, Chris

    2017-01-01

    The pace of innovation in radiation oncology is high and the window of opportunity for evaluation narrow. Financial incentives, industry pressure, and patients' demand for high-tech treatments have led to widespread implementation of innovations before, or even without, robust evidence of improved outcomes has been generated. The standard phase I-IV framework for drug evaluation is not the most efficient and desirable framework for assessment of technological innovations. In order to provide a standard assessment methodology for clinical evaluation of innovations in radiotherapy, we adapted the surgical IDEAL framework to fit the radiation oncology setting. Like surgery, clinical evaluation of innovations in radiation oncology is complicated by continuous technical development, team and operator dependence, and differences in quality control. Contrary to surgery, radiotherapy innovations may be used in various ways, e.g., at different tumor sites and with different aims, such as radiation volume reduction and dose escalation. Also, the effect of radiation treatment can be modeled, allowing better prediction of potential benefits and improved patient selection. Key distinctive features of R-IDEAL include the important role of predicate and modeling studies (Stage 0), randomization at an early stage in the development of the technology, and long-term follow-up for late toxicity. We implemented R-IDEAL for clinical evaluation of a recent innovation in radiation oncology, the MRI-guided linear accelerator (MR-Linac). MR-Linac combines a radiotherapy linear accelerator with a 1.5-T MRI, aiming for improved targeting, dose escalation, and margin reduction, and is expected to increase the use of hypofractionation, improve tumor control, leading to higher cure rates and less toxicity. An international consortium, with participants from seven large cancer institutes from Europe and North America, has adopted the R-IDEAL framework to work toward coordinated, evidence

  19. Mechanical properties of thin-film materials evaluated from amplitude-dependent internal friction

    Science.gov (United States)

    Nishino, Yoichi

    1999-09-01

    A method is presented to evaluate the mechanical properties of thin-film materials from measurements of the amplitude-dependent internal friction. According to the constitutive equation, the internal friction in the film can be determined separately from measured damping of the film/substrate composite. The internal friction in aluminum films is dependent on the strain amplitude that is approximately two orders of magnitude higher than that for bulk aluminum. On the basis of the microplasticity theory, the amplitude-dependent internal friction in the film can be converted into the plastic strain as a function of effective stress on dislocation motion. The mechanical responses thus obtained for aluminum films show that the plastic strain of the order of 10-9 increases nonlinearly with increasing stress. These curves tend to shift to a higher stress with decreasing film thickness and also with decreasing temperature, both indicating a suppression of microplastic flow. The microflow stress at a constant level of the plastic strain varies inversely with the film thickness, provided the grain size is larger than the film thickness. The film thickness effect in the microplastic range can be well explained by the bowing of a dislocation segment whose ends are pinned at the film surface and at the film/substrate interface.

  20. Evaluation of macrocirculatory endothelium-dependent and endothelium-independent vasoreactivity in vascular disease.

    Science.gov (United States)

    Abularrage, Christopher J; Sidawy, Anton N; Aidinian, Gilbert; Singh, Niten; Weiswasser, Jonathan M; Arora, Subodh

    2005-09-01

    Macrocirculatory endothelium-dependent and independent vasodilatation is integral to tissue-bed oxygen delivery and homeostasis. Dysfunction of macrocirculatory vasoreactivity is a precursor to atherosclerosis and occurs in a similar fashion in multiple tissue beds long before the onset of symptoms. Impaired macrocirculatory vasodilatation has been shown to occur in certain disease states including diabetes mellitus, hypercholesterolemia, chronic renal failure, peripheral arterial atherosclerosis, and abdominal aortic aneurysms, as well as secondary to smoking, advanced age, menopause, high-fat diet, and sedentary lifestyle. Brachial artery vasoreactivity is a noninvasive means of assessing macrocirculatory vasodilatory capacity that may help identify patients at increased risk for peripheral and cardiovascular disease and allow for objective assessment and monitoring of treatment. Endothelium-dependent vasoreactivity, or flow-mediated dilatation, is measured after brachial artery occlusion with a pneumatic blood pressure cuff, and endothelium-independent vasoreactivity is measured after the administration of sublingual nitroglycerin. The accuracy of brachial artery vasoreactivity is dependent on hematologic variables, as well as diurnal, day-to-day, ultrasound operator, and reader variations; however, the overall coefficient of variation is only 1.8%. We discuss the importance of the macrocirculation, investigative methods for evaluating macrocirculatory vasoreactivity, and review the literature of vasoreactivity in these different states.

  1. A Systematic Review of the Level of Evidence in Economic Evaluations of Medical Devices: The Example of Vertebroplasty and Kyphoplasty.

    Science.gov (United States)

    Martelli, Nicolas; Devaux, Capucine; van den Brink, Hélène; Pineau, Judith; Prognon, Patrice; Borget, Isabelle

    2015-01-01

    Economic evaluations are far less frequently reported for medical devices than for drugs. In addition, little is known about the quality of existing economic evaluations, particularly for innovative devices, such as those used in vertebroplasty and kyphoplasty. To assess the level of evidence provided by the available economic evaluations for vertebroplasty and kyphoplasty. A systematic review of articles in English or French listed in the MEDLINE, PASCAL, COCHRANE and National Health Service Economic Evaluation databases, with limits on publication date (up to the date of the review, March 2014). We included only economic evaluations of vertebroplasty or kyphoplasty. Editorial and methodological articles were excluded. Data were extracted from articles by two authors working independently and using two analysis grids to measure the quality of economic evaluations. Twenty-one studies met our inclusion criteria. All were published between 2008 and 2014. Eighteen (86%) were full economic evaluations. Cost-effectiveness analysis (CEA) was the most frequent type of economic evaluation, and was present in 11 (52%) studies. Only three CEAs complied fully with the British Medical Journal checklist. The quality of the data sources used in the 21 studies was high, but the CEAs conforming to methodological guidelines did not use high-quality data sources for all components of the analysis. This systematic review shows that the level of evidence in economic evaluations of vertebroplasty and kyphoplasty is low, despite the recent publication of a large number of studies. This finding highlights the challenges to be faced to improve the quality of economic evaluations of medical devices.

  2. A Systematic Review of the Level of Evidence in Economic Evaluations of Medical Devices: The Example of Vertebroplasty and Kyphoplasty.

    Directory of Open Access Journals (Sweden)

    Nicolas Martelli

    Full Text Available Economic evaluations are far less frequently reported for medical devices than for drugs. In addition, little is known about the quality of existing economic evaluations, particularly for innovative devices, such as those used in vertebroplasty and kyphoplasty.To assess the level of evidence provided by the available economic evaluations for vertebroplasty and kyphoplasty.A systematic review of articles in English or French listed in the MEDLINE, PASCAL, COCHRANE and National Health Service Economic Evaluation databases, with limits on publication date (up to the date of the review, March 2014.We included only economic evaluations of vertebroplasty or kyphoplasty. Editorial and methodological articles were excluded.Data were extracted from articles by two authors working independently and using two analysis grids to measure the quality of economic evaluations.Twenty-one studies met our inclusion criteria. All were published between 2008 and 2014. Eighteen (86% were full economic evaluations. Cost-effectiveness analysis (CEA was the most frequent type of economic evaluation, and was present in 11 (52% studies. Only three CEAs complied fully with the British Medical Journal checklist. The quality of the data sources used in the 21 studies was high, but the CEAs conforming to methodological guidelines did not use high-quality data sources for all components of the analysis.This systematic review shows that the level of evidence in economic evaluations of vertebroplasty and kyphoplasty is low, despite the recent publication of a large number of studies. This finding highlights the challenges to be faced to improve the quality of economic evaluations of medical devices.

  3. Diagnostic tests and algorithms used in the investigation of haematuria: systematic reviews and economic evaluation.

    Science.gov (United States)

    Rodgers, M; Nixon, J; Hempel, S; Aho, T; Kelly, J; Neal, D; Duffy, S; Ritchie, G; Kleijnen, J; Westwood, M

    2006-06-01

    To determine the most effective diagnostic strategy for the investigation of microscopic and macroscopic haematuria in adults. Electronic databases from inception to October 2003, updated in August 2004. A systematic review was undertaken according to published guidelines. Decision analytic modelling was undertaken, based on the findings of the review, expert opinion and additional information from the literature, to assess the relative cost-effectiveness of plausible alternative tests that are part of diagnostic algorithms for haematuria. A total of 118 studies met the inclusion criteria. No studies that evaluated the effectiveness of diagnostic algorithms for haematuria or the effectiveness of screening for haematuria or investigating its underlying cause were identified. Eighteen out of 19 identified studies evaluated dipstick tests and data from these suggested that these are moderately useful in establishing the presence of, but cannot be used to rule out, haematuria. Six studies using haematuria as a test for the presence of a disease indicated that the detection of microhaematuria cannot alone be considered a useful test either to rule in or rule out the presence of a significant underlying pathology (urinary calculi or bladder cancer). Forty-eight of 80 studies addressed methods to localise the source of bleeding (renal or lower urinary tract). The methods and thresholds described in these studies varied greatly, precluding any estimate of a 'best performance' threshold that could be applied across patient groups. However, studies of red blood cell morphology that used a cut-off value of 80% dysmorphic cells for glomerular disease reported consistently high specificities (potentially useful in ruling in a renal cause for haematuria). The reported sensitivities were generally low. Twenty-eight studies included data on the accuracy of laboratory tests (tumour markers, cytology) for the diagnosis of bladder cancer. The majority of tumour marker studies

  4. [Taking evaluation of post-marketing as point of cut-in to promote systematic research of traditional Chinese medicine].

    Science.gov (United States)

    Wang, Yong-yan; Wang, Zhi-fei; Xie, Yan-ming

    2014-09-01

    Research on post-marketing Chinese medicine should be the systematic study from application to mechanism. Clinical evaluation is the basis of mechanism study, we can find the clue from clinical evaluation, then make a mechanism study to find the reason, then apply the results to clinic. So it is a virtuous circle. In order to achieve it, we cannot be limited to traditional Chinese medicine, we should form multi-disciplinary team under the direction of grand science thinking, try hard to put industry-university-research institute collaboration association to use, and if necessary, explore the new model of the whole nation system. An appropriate operation mechanism is very important.

  5. How good are current approaches to nonclinical evaluation of abuse and dependence?

    Science.gov (United States)

    Moser, Paul; Wolinsky, Toni; Duxon, Mark; Porsolt, Roger D

    2011-03-01

    Nonclinical assessment of drug abuse and dependence is the subject of several recent regulatory guidelines, which are generally aligned on the methods to be employed. The most direct approach to assessing reinforcing properties of a drug is the self-administration procedure whereby animals can initiate intravenous injections of the test substance, something they readily do with prototypic drugs of abuse. Complications arise because there is no standardized procedure for evaluating substances with differing potencies, reinforcement properties, or pharmacokinetics. Moreover, the choice of training substance, species, and procedural parameters can radically affect the outcome. Apart from the lower cost of rats, primates present several advantages for self-administration studies with similarity to human pharmacokinetics in particular. The most powerful method for assessing similarities between a test substance and a prototypic drug of abuse is the drug discrimination procedure. In contrast to self-administration, drug discrimination is pharmacologically very specific, often reflecting functional activity at receptor level. Dependence is assessed by the occurrence of withdrawal effects on drug discontinuation. Although conceptually simple, interpretation can be complicated by factors such as duration and frequency of administration and observations as well as the choice of end points. Telemetry allows continuous observation of multiple parameters during withdrawal, thereby increasing sensitivity. Presently available tools identify all substances known to cause abuse or dependence, with little risk of false-positives. It remains unclear, however, how predictive these models are with entirely novel substances. Nonetheless, drug abuse/dependence is an area of safety pharmacology where the predictive value of animal models is remarkably high.

  6. Immunosuppressive therapy for kidney transplantation in children and adolescents: systematic review and economic evaluation.

    Science.gov (United States)

    Haasova, Marcela; Snowsill, Tristan; Jones-Hughes, Tracey; Crathorne, Louise; Cooper, Chris; Varley-Campbell, Jo; Mujica-Mota, Ruben; Coelho, Helen; Huxley, Nicola; Lowe, Jenny; Dudley, Jan; Marks, Stephen; Hyde, Chris; Bond, Mary; Anderson, Rob

    2016-08-01

    End-stage renal disease is a long-term irreversible decline in kidney function requiring kidney transplantation, haemodialysis or peritoneal dialysis. The preferred option is kidney transplantation followed by induction and maintenance immunosuppressive therapy to reduce the risk of kidney rejection and prolong graft survival. To systematically review and update the evidence for the clinical effectiveness and cost-effectiveness of basiliximab (BAS) (Simulect,(®) Novartis Pharmaceuticals) and rabbit antihuman thymocyte immunoglobulin (Thymoglobuline,(®) Sanofi) as induction therapy and immediate-release tacrolimus [Adoport(®) (Sandoz); Capexion(®) (Mylan); Modigraf(®) (Astellas Pharma); Perixis(®) (Accord Healthcare); Prograf(®) (Astellas Pharma); Tacni(®) (Teva); Vivadex(®) (Dexcel Pharma)], prolonged-release tacrolimus (Advagraf,(®) Astellas Pharma); belatacept (BEL) (Nulojix,(®) Bristol-Myers Squibb), mycophenolate mofetil (MMF) [Arzip(®) (Zentiva), CellCept(®) (Roche Products), Myfenax(®) (Teva), generic MMF is manufactured by Accord Healthcare, Actavis, Arrow Pharmaceuticals, Dr Reddy's Laboratories, Mylan, Sandoz and Wockhardt], mycophenolate sodium, sirolimus (Rapamune,(®) Pfizer) and everolimus (Certican,(®) Novartis Pharmaceuticals) as maintenance therapy in children and adolescents undergoing renal transplantation. Clinical effectiveness searches were conducted to 7 January 2015 in MEDLINE (via Ovid), EMBASE (via Ovid), Cochrane Central Register of Controlled Trials (via Wiley Online Library) and Web of Science [via Institute for Scientific Information (ISI)], Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and Health Technology Assessment (HTA) (The Cochrane Library via Wiley Online Library) and Health Management Information Consortium (via Ovid). Cost-effectiveness searches were conducted to 15 January 2015 using a costs or economic literature search filter in MEDLINE (via Ovid), EMBASE (via Ovid), NHS

  7. Guideline for Performing Systematic Approach to Evaluate and Qualify Legacy Documents that Support Advanced Reactor Technology Activity

    Energy Technology Data Exchange (ETDEWEB)

    Honma, George [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-10-01

    The establishment of a systematic process for the evaluation of historic technology information for use in advanced reactor licensing is described. Efforts are underway to recover and preserve Experimental Breeder Reactor II and Fast Flux Test Facility historical data. These efforts have generally emphasized preserving information from data-acquisition systems and hard-copy reports and entering it into modern electronic formats suitable for data retrieval and examination. The guidance contained in this document has been developed to facilitate consistent and systematic evaluation processes relating to quality attributes of historic technical information (with focus on sodium-cooled fast reactor (SFR) technology) that will be used to eventually support licensing of advanced reactor designs. The historical information may include, but is not limited to, design documents for SFRs, research-and-development (R&D) data and associated documents, test plans and associated protocols, operations and test data, international research data, technical reports, and information associated with past U.S. Nuclear Regulatory Commission (NRC) reviews of SFR designs. The evaluation process is prescribed in terms of SFR technology, but the process can be used to evaluate historical information for any type of advanced reactor technology. An appendix provides a discussion of typical issues that should be considered when evaluating and qualifying historical information for advanced reactor technology fuel and source terms, based on current light water reactor (LWR) requirements and recent experience gained from Next Generation Nuclear Plant (NGNP).

  8. The effect of a geriatric evaluation on treatment decisions for older cancer patients--a systematic review.

    Science.gov (United States)

    Hamaker, Marije E; Schiphorst, Anandi H; ten Bokkel Huinink, Daan; Schaar, Cees; van Munster, Barbara C

    2014-03-01

    The aim of this systematic review is to summarise all available data on the effect of a geriatric evaluation on the multidisciplinary treatment of older cancer patients, focussing on oncologic treatment decisions and the implementation of non-oncologic interventions. A systematic search in MEDLINE and EMBASE for studies on the effect of a geriatric evaluation on oncologic and non-oncologic treatment for older cancer patients. Literature search identified 1654 reports (624 from Medline and 1030 from Embase), of which 10 studies were included in the review. Three studies used a geriatric consultation while seven used a geriatric assessment performed by a cancer specialist, healthcare worker or (research) nurse. Six studies addressed a change in oncologic treatment, the initial treatment plan was modified in a median of 39% of patients after geriatric evaluation, of which two thirds resulted in less intensive treatment. Seven studies focused on the implementation of non-oncologic interventions based on the results of the geriatric evaluation; all but one reported that interventions were suggested for over 70% of patients, even in studies that did not focus specifically on frail older patients. In the other study, implementation of non-oncologic interventions was left to the cancer specialist's discretion. A geriatric evaluation has significant impact on oncologic and non-oncologic treatment decisions in older cancer patients and deserves consideration in the oncologic work-up for these patients.

  9. Patient autonomy problems in palliative care: systematic development and evaluation of a questionnaire.

    NARCIS (Netherlands)

    Vernooy-Dassen, M.J.F.J.; Osse, B.H.P.; Schade, E.; Grol, R.P.T.M.

    2005-01-01

    No instrument to assess autonomy problems in palliative care is currently available. The purpose of this study was to develop a comprehensive and concise questionnaire to measure autonomy problems in palliative cancer patients and to study its validity and reliability. We systematically developed a

  10. Magnetic resonance imaging for evaluation of disease activity in Crohn's disease: a systematic review

    NARCIS (Netherlands)

    Horsthuis, Karin; Bipat, Shandra; Stokkers, Pieter C. F.; Stoker, Jaap

    2009-01-01

    To systematically review the evidence on the accuracy of MRI for grading disease activity in Crohn's disease (CD). The MEDLINE, EMBASE, CINAHL and Cochrane databases were searched for studies on the accuracy of MRI in grading CD compared to a predefined reference standard. Two independent observers

  11. Cost-effectiveness of conservative treatments for neck pain: a systematic review on economic evaluations

    NARCIS (Netherlands)

    Driessen, Maurice T; Lin, Chung-Wei C.; van Tulder, Maurits W

    2012-01-01

    PURPOSE: Various conservative interventions have been used for the treatment of non-specific neck pain. The aim of this systematic review was to investigate the cost-effectiveness of conservative treatments for non-specific neck pain. METHODS: Clinical and economic electronic databases, reference

  12. How are "teaching the teachers" courses in evidence based medicine evaluated? A systematic review

    NARCIS (Netherlands)

    Walczak, Jacek; Kaleta, Anna; Gabrys, Elzbieta; Kloc, Krzysztof; Thangaratinam, Shakila; Barnfield, Gemma; Weinbrenner, Susanne; Meyerrose, Berit; Arvanitis, Theodores N.; Horvath, Andrea R.; Zanrei, Gianni; Kunz, Regina; Suter, Katja; Burnand, Bernard; Arditi, Chantal; Oude Rengerink, Katrien; Harry, Gee; Mol, Ben W. J.; Khan, Khalid S.

    2010-01-01

    ABSTRACT: BACKGROUND: Teaching of evidence-based medicine (EBM) has become widespread in medical education. Teaching the teachers (TTT) courses address the increased teaching demand and the need to improve effectiveness of EBM teaching. We conducted a systematic review of assessment tools for EBM

  13. Systematic Evaluation of Pleiotropy Identifies 6 Further Loci Associated With Coronary Artery Disease

    NARCIS (Netherlands)

    Webb, Thomas R.; Erdmann, Jeanette; Stirrups, Kathleen E.; Stitziel, Nathan O.; Masca, Nicholas G. D.; Jansen, Henning; Kanoni, Stavroula; Nelson, Christopher P.; Ferrario, Paola G.; König, Inke R.; Eicher, John D.; Johnson, Andrew D.; Hamby, Stephen E.; Betsholtz, Christer; Ruusalepp, Arno; Franzén, Oscar; Schadt, Eric E.; Björkegren, Johan L. M.; Weeke, Peter E.; Auer, Paul L.; Schick, Ursula M.; Lu, Yingchang; Zhang, He; Dube, Marie-Pierre; Goel, Anuj; Farrall, Martin; Peloso, Gina M.; Won, Hong-Hee; Do, Ron; van Iperen, Erik; Kruppa, Jochen; Mahajan, Anubha; Scott, Robert A.; Willenborg, Christina; Braund, Peter S.; van Capelleveen, Julian C.; Doney, Alex S. F.; Donnelly, Louise A.; Asselta, Rosanna; Merlini, Pier A.; Duga, Stefano; Marziliano, Nicola; Denny, Josh C.; Shaffer, Christian; El-Mokhtari, Nour Eddine; Franke, Andre; Heilmann, Stefanie; Hengstenberg, Christian; Hoffmann, Per; Holmen, Oddgeir L.; Hveem, Kristian; Jansson, Jan-Håkan; Jöckel, Karl-Heinz; Kessler, Thorsten; Kriebel, Jennifer; Laugwitz, Karl L.; Marouli, Eirini; Martinelli, Nicola; McCarthy, Mark I.; van Zuydam, Natalie R.; Meisinger, Christa; Esko, Tõnu; Mihailov, Evelin; Escher, Stefan A.; Alver, Maris; Moebus, Susanne; Morris, Andrew D.; Virtamo, Jarma; Nikpay, Majid; Olivieri, Oliviero; Provost, Sylvie; AlQarawi, Alaa; Robertson, Neil R.; Akinsansya, Karen O.; Reilly, Dermot F.; Vogt, Thomas F.; Yin, Wu; Asselbergs, Folkert W.; Kooperberg, Charles; Jackson, Rebecca D.; Stahl, Eli; Müller-Nurasyid, Martina; Strauch, Konstantin; Varga, Tibor V.; Waldenberger, Melanie; Zeng, Lingyao; Chowdhury, Rajiv; Salomaa, Veikko; Ford, Ian; Jukema, J. Wouter; Amouyel, Philippe; Kontto, Jukka; Nordestgaard, Børge G.; Ferrières, Jean; Saleheen, Danish; Sattar, Naveed; Surendran, Praveen; Wagner, Aline; Young, Robin; Howson, Joanna M. M.; Butterworth, Adam S.; Danesh, John; Ardissino, Diego; Bottinger, Erwin P.; Erbel, Raimund; Franks, Paul W.; Girelli, Domenico; Hall, Alistair S.; Hovingh, G. Kees; Kastrati, Adnan; Lieb, Wolfgang; Meitinger, Thomas; Kraus, William E.; Shah, Svati H.; McPherson, Ruth; Orho-Melander, Marju; Melander, Olle; Metspalu, Andres; Palmer, Colin N. A.; Peters, Annette; Rader, Daniel J.; Reilly, Muredach P.; Loos, Ruth J. F.; Reiner, Alex P.; Roden, Dan M.; Tardif, Jean-Claude; Thompson, John R.; Wareham, Nicholas J.; Watkins, Hugh; Willer, Cristen J.; Samani, Nilesh J.; Schunkert, Heribert; Deloukas, Panos; Kathiresan, Sekar

    2017-01-01

    Genome-wide association studies have so far identified 56 loci associated with risk of coronary artery disease (CAD). Many CAD loci show pleiotropy; that is, they are also associated with other diseases or traits. This study sought to systematically test if genetic variants identified for non-CAD

  14. A systematic review of studies evaluating Australian indigenous community development projects

    NARCIS (Netherlands)

    Snijder, Mieke; Shakeshaft, Anthony; Wagemakers, Annemarie; Stephens, Anne; Calabria, Bianca

    2015-01-01

    Background: Community development is a health promotion approach identified as having great potential to improve Indigenous health, because of its potential for extensive community participation. There has been no systematic examination of the extent of community participation in community

  15. Integration of Medical Images to the Teaching of Systematic Pathology: An Evaluation of Relevance

    Science.gov (United States)

    Starkey, Deborah

    2011-01-01

    A sound knowledge of pathological disease processes is required for professional practice within health professions. The project described in this paper reviewed the resources currently available for the delivery of systematic pathology tutorials. Additional complementary resources were developed and the inclusion of these additional learning…

  16. Eccentric training for prevention of hamstring injuries may depend on intervention compliance: a systematic review and meta-analysis.

    Science.gov (United States)

    Goode, Adam P; Reiman, Michael P; Harris, Lloyd; DeLisa, Lucia; Kauffman, Aaron; Beltramo, David; Poole, Charles; Ledbetter, Leila; Taylor, Andrea B

    2015-03-01

    Hamstring injury is a prevalent muscle injury in sports. Inconclusive evidence exists for eccentric hamstring strengthening to prevent hamstring injuries. One reason for this discrepancy may be the influence intervention non-compliance has on individual study estimates, and therefore pooled estimates. This systematic review aims to determine the effect of eccentric hamstring strengthening on the risk of hamstring injury and quantitatively explores the impact of intervention non-compliance on the precision, heterogeneity and strength of pooled estimates. A computer-assisted literature search of Medline, CINAHL, Cochrane, EMBASE, AMED, SportDiscus and PEDro databases was conducted with keywords related to eccentric strengthening and hamstring injury. The search was conducted from the end of a previous comprehensive review forward (1 December 2008 to 31 December 2013). Random-effects models were used for both main effects and a sensitivity analysis. Pooled estimate precision was measured with a confidence limit ratio (confidence limit ratio (CLR); upper limit divided by the lower limit) and heterogeneity was assessed with I(2), Cochrane's-Q and τ(2). A protocol was not registered for this review. Four out of 349 studies met the inclusion criteria. In main effects analysis, eccentric hamstring training did not reduce the risk of hamstring injury (risk ratio [RR]=0.59 ((95% CI 0.24 to 1.44)). This estimate was imprecise (CLR=6.0) with significant heterogeneity (p value 0.02, 69.6% variation and t(2)=0.57). Subjects compliant with eccentric strengthening had a significant (RR=0.35 ((95% CI 0.23 to 0.55)) reduction in hamstring injuries. This estimate was precise (CLR=2.4) and homogenous (p value=0.38, 2.8% variation and t(2)=0.007). The null-biased effect in using intent-to-treat methods from intervention non-compliance has a substantial impact on the precision, heterogeneity and the direction and strength of pooled estimates. Eccentric strengthening, with good

  17. Evaluating the safety and immunogenicity of yellow fever vaccines: a systematic review

    Directory of Open Access Journals (Sweden)

    Thomas RE

    2015-04-01

    Full Text Available Roger E Thomas Department of Family Medicine, G012 Health Sciences Center, University of Calgary Medical School, Calgary, AB, Canada Purpose: To review the safety and immunogenicity of yellow fever vaccines. Literature search: The Cochrane Library (including the Cochrane CENTRAL Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and the NHS Database of Abstracts of Reviews of Effects; MEDLINE; EMBASE; BIOSIS Previews; Global Health; CAB Abstracts; and the Lilacs Database of Latin American and Caribbean literature were searched for individual studies and systematic reviews through January 1, 2015. Results: Six yellow fever vaccines are currently produced, and they are effective against all seven yellow fever virus strains. There is a 99.2% homology of the genome sequences of the six current vaccines. Four systematic reviews identified very small numbers of serious adverse events. A systematic review (updated of all published cases identified 133 serious adverse events that met the Brighton Collaboration criteria: 32 anaphylactic, 42 neurologic (one death, 57 viscerotropic (25 deaths, and two of both neurologic and viscerotropic SAEs. The Sanofi Pasteur Global Pharmacovigilance database reported 276 million doses of Stamaril™ distributed worldwide and identified 12 reports of yellow fever vaccine-associated viscerotropic disease (YEL-AVD, 24 of yellow fever vaccine-associated neurologic disease (YEL-AND, and 33 reports of anaphylaxis (many already published. The Biomanguinhos manufacturer's database reported 110 million doses distributed worldwide between 1999 and 2009, and the rate of YEL-AND was estimated at 0.084/100,000 doses distributed and YEL-AVD at 0.02/100,000 doses distributed. Conclusion: Reports of serious adverse events are mostly from travelers from developed countries, and there is likely serious underreporting for developing countries. On the basis of the published reports, the yellow fever vaccines are

  18. Cancer evaluation in the assessment of solid organ transplant candidates: A systematic review of clinical practice guidelines.

    Science.gov (United States)

    Acuna, Sergio A; Lam, Winnie; Daly, Corinne; Kim, S Joseph; Baxter, Nancy N

    2018-01-01

    Active malignancies are a contraindication to transplantation, as immunosuppression can lead to worse cancer outcomes; therefore, ensuring transplant candidates are free of malignancy before transplantation is essential. This systematic review assesses the availability, quality, and consistency of recommended cancer evaluation prior to transplantation in Clinical Practice Guidelines (CPGs) for the selection of solid organ transplant candidates. We systematically searched for CPGs for the assessment of transplant candidates. The characteristics of included CPGs, strength of recommendations and supporting evidence were extracted. A quality assessment of the CPGs was conducted using the AGREE II tool. We identified 52 CPG for the selection of solid organ transplant candidates. Only 13 (25%) included recommendations for cancer evaluation as part of the assessment of transplant candidates. Most recommended age and sex appropriate cancer screening as per the general population guidelines. Recommendations to evaluate for other malignancies and for high-risk candidates were variable. Most recommendations were based on expert opinion and only two CPGs provided an explicit link between the recommendations and supporting evidence. There is a lack of clear and consistent recommendations for pretransplant cancer evaluation in existing CPGs. Although there is some consensus regarding the indication to screen for cancer as per the recommendations for the general population, these recommendations are not an appropriate risk reduction strategy for transplant candidates. Standardized protocols to ensure transplant candidates are cancer free prior to transplantation are needed. Copyright © 2017. Published by Elsevier Inc.

  19. Critical appraisal of the literature on economic evaluations of substitution of skills between professionals: a systematic literature review.

    Science.gov (United States)

    Dierick-van Daele, Angelique T M; Spreeuwenberg, Cor; Derckx, Emmy W C C; Metsemakers, Job F M; Vrijhoef, Bert J M

    2008-08-01

    Substitution of skills has been introduced to increase health service efficiency, but little evidence is available about its cost-effectiveness. This systematic review aims to identify economic evaluations of substitution between professionals, to assess the quality of the study methods applied and to value the results for decision making. Publications between January 1996 and November 2006 were searched in Medline, Cochrane, Cinahl, database of Health Technology Assessments, EPOC and Embase. Randomized controlled trials (RCTs), cost-benefit analysis, interrupted time series design and systematic reviews were selected. The methodological quality of the papers was reviewed, using the critical appraisal of Drummond and the EPOC list. Eleven studies were finally included of 7605 studies: three cost-effectiveness studies, three cost-minimization studies and five studies related to partial economic evaluations. Small numbers of participating professionals and several limitations in the cost valuation and the measurement of costs were identified. Several potential limitations influence the validity and generalizability. Full economic evaluations per se are of limited value for making decisions about substitution of skills. The tenuous relationship between structural, process and outcome variables is not sufficient investigated. For meaningfully placing the costs and consequences of substitution of skills in the context of health care and generating relevant data for decision making, it is strongly recommended to combine an economic evaluation (RCT) with an observational longitudinal study.

  20. Systematic Correlation Matrix Evaluation (SCoMaE) - a bottom-up, science-led approach to identifying indicators

    Science.gov (United States)

    Mengis, Nadine; Keller, David P.; Oschlies, Andreas

    2018-01-01

    This study introduces the Systematic Correlation Matrix Evaluation (SCoMaE) method, a bottom-up approach which combines expert judgment and statistical information to systematically select transparent, nonredundant indicators for a comprehensive assessment of the state of the Earth system. The methods consists of two basic steps: (1) the calculation of a correlation matrix among variables relevant for a given research question and (2) the systematic evaluation of the matrix, to identify clusters of variables with similar behavior and respective mutually independent indicators. Optional further analysis steps include (3) the interpretation of the identified clusters, enabling a learning effect from the selection of indicators, (4) testing the robustness of identified clusters with respect to changes in forcing or boundary conditions, (5) enabling a comparative assessment of varying scenarios by constructing and evaluating a common correlation matrix, and (6) the inclusion of expert judgment, for example, to prescribe indicators, to allow for considerations other than statistical consistency. The example application of the SCoMaE method to Earth system model output forced by different CO2 emission scenarios reveals the necessity of reevaluating indicators identified in a historical scenario simulation for an accurate assessment of an intermediate-high, as well as a business-as-usual, climate change scenario simulation. This necessity arises from changes in prevailing correlations in the Earth system under varying climate forcing. For a comparative assessment of the three climate change scenarios, we construct and evaluate a common correlation matrix, in which we identify robust correlations between variables across the three considered scenarios.

  1. Evaluation of two types of leukocyte removal filters on transfusion dependent thalassaemics.

    Science.gov (United States)

    Jamal, R; Mazeni, N R; Hussin, H

    2000-12-01

    The advent of leukocyte filters has enabled effective removal of leukocytes from certain blood products thus avoiding many adverse effects of blood transfusion. Many different materials have been incorporated into these filters to achieve >95% leukocyte removal. In this study we evaluated the efficacy of leukocyte removal of two different filters, using actual bedside transfusion settings involving patients with transfusion dependent thalassaemia. Fifty-one transfusion events were randomised to use either a polyurethane filter or a non-woven polyester filter. We found that the two filters achieved 98.4% and 96.2% leukocyte removal respectively (p = 0.022). We also found no significant correlation between pre-filtration white blood cell count and the volume transfused with the efficacy of leukodepletion. No untoward events or transfusion reactions were observed during the study.

  2. Subjective evaluation of running footwear depends on country and assessment method: a bi-national study.

    Science.gov (United States)

    Kong, Pui W; Lim, Chen Y; Ding, Rui; Sterzing, Thorsten

    2015-01-01

    This study examined (1) the perception of running shoes between China (Beijing) and Singapore and (2) whether running shoe preference depended on assessment methods. One hundred (n = 50 each country) Chinese males subjectively evaluated four shoe models during running by using two assessment procedures. Procedure 1 used a visual analogue scale (VAS) to assess five perception variables. Procedure 2 was a 'head-to-head' comparison of two shoes simultaneously (e.g. left foot: A and right foot: B) to decide which model was preferred. VAS scores were consistently higher in Beijing participants (p shoe discrimination. Moderate agreement was seen between the VAS and 'head-to-head' procedures, with only 14 out of 100 participants matched all 6 pairwise comparisons (median = 4 matches). Footwear companies and researchers should be aware that subjective shoe preference may vary with assessment methods. Practitioner Summary: Footwear preference depends on country and assessment methods. Running shoe perception differed between Beijing and Singapore Chinese, suggesting that footwear recommendation should be country-specific. Individuals' shoe preference measured by visual analogue scale when wearing complete pairs may not reflect that when directly comparing different models in left and right feet.

  3. Allowance for radial dilution in evaluating the concentration dependence of sedimentation coefficients for globular proteins.

    Science.gov (United States)

    Patel, Trushar R; Winzor, Donald J; Scott, David J

    2017-10-04

    The accuracy with which the concentration dependence of the sedimentation coefficient, s = s 0(1 - kc), can be quantified for globular proteins by commonly used procedures has been examined by subjecting simulated sedimentation velocity distributions for ovalbumin to c(s)‒s analysis. Because this procedure, as well as its g(s)‒s counterpart, is based on assumed constancy of s over the time course of sedimentation coefficient measurement in a given experiment, the best definition of the concentration coefficient k is obtained by associating the measured s with the mean of plateau concentrations for the initial and final distributions used for its determination. The return of a slightly underestimated k (by about 3%) is traced to minor mislocation of the air‒liquid meniscus position as the result of assuming time independence of s in a given experiment. Although more accurate quantification should result from later SEDFIT and SEDANAL programs incorporating the simultaneous evaluation of s 0 and k, the procedures based on assumed constancy of s suffice for determining the limiting sedimentation coefficient s 0-the objective of most s‒c dependence studies.

  4. Double-blind placebo-controlled evaluation of the PROMETA™ protocol for methamphetamine dependence.

    Science.gov (United States)

    Ling, Walter; Shoptaw, Steven; Hillhouse, Maureen; Bholat, Michelle A; Charuvastra, Charles; Heinzerling, Keith; Chim, David; Annon, Jeffrey; Dowling, Patrick T; Doraimani, Geetha

    2012-02-01

    To evaluate the efficacy and safety of the PROMETA™ Protocol for treating methamphetamine dependence. A double-blind, placebo-controlled 108-day study with random assignment to one of two study conditions: active medication with flumazenil (2 mg infusions on days 1, 2, 3, 22, 23), gabapentin (1200 mg to day 40) and hydroxazine (50 mg to day 10) versus placebo medication (with active hydroxazine only). Three substance abuse treatment clinics: two in-patient, one out-patient. Treatment-seeking, methamphetamine-dependent adults (n = 120). Primary outcome was percentage of urine samples testing negative for methamphetamine during the trial. No statistically significant between-group differences were detected in urine drug test results, craving, treatment retention or adverse events. The PROMETA protocol, consisting of flumazenil, gabapentin and hydroxyzine, appears to be no more effective than placebo in reducing methamphetamine use, retaining patients in treatment or reducing methamphetamine craving. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

  5. Environmental Indicators for the Evaluation of Wood Products in Consideration of Site-Dependent Aspects: A Review and Integrated Approach

    National Research Council Canada - National Science Library

    Nadine May; Edeltraud Guenther; Peer Haller

    2017-01-01

    .... The aim of this study is to identify existing environmental indicators and methods for an evaluation of the sustainability of wood products in consideration of all life cycle stages, site-dependent...

  6. Evaluating the time-dependent and bond characteristics of lightweight concrete mixes for Kansas prestressed concrete bridges.

    Science.gov (United States)

    2011-07-01

    This report details results from testing that was conducted to determine the bond and time-dependent : characteristics of two lightweight concrete mixes. The lightweight mixes were evaluated to possibly : provide a more cost-effective solution to rep...

  7. Instruments evaluating the quality of the clinical learning environment in nursing education: A systematic review of psychometric properties.

    Science.gov (United States)

    Mansutti, Irene; Saiani, Luisa; Grassetti, Luca; Palese, Alvisa

    2017-03-01

    The clinical learning environment is fundamental to nursing education paths, capable of affecting learning processes and outcomes. Several instruments have been developed in nursing education, aimed at evaluating the quality of the clinical learning environments; however, no systematic review of the psychometric properties and methodological quality of these studies has been performed to date. The aims of the study were: 1) to identify validated instruments evaluating the clinical learning environments in nursing education; 2) to evaluate critically the methodological quality of the psychometric property estimation used; and 3) to compare psychometric properties across the instruments available. A systematic review of the literature (using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines) and an evaluation of the methodological quality of psychometric properties (using the COnsensus-based Standards for the selection of health Measurement INstruments guidelines). The Medline and CINAHL databases were searched. Eligible studies were those that satisfied the following criteria: a) validation studies of instruments evaluating the quality of clinical learning environments; b) in nursing education; c) published in English or Italian; d) before April 2016. The included studies were evaluated for the methodological quality of the psychometric properties measured and then compared in terms of both the psychometric properties and the methodological quality of the processes used. The search strategy yielded a total of 26 studies and eight clinical learning environment evaluation instruments. A variety of psychometric properties have been estimated for each instrument, with differing qualities in the methodology used. Concept and construct validity were poorly assessed in terms of their significance and rarely judged by the target population (nursing students). Some properties were rarely considered (e.g., reliability, measurement error

  8. Evaluating state dependence and subtype selectivity of calcium channel modulators in automated electrophysiology assays.

    Science.gov (United States)

    Kuryshev, Yuri A; Brown, Arthur M; Duzic, Emir; Kirsch, Glenn E

    2014-03-01

    Voltage-gated Ca2+ channels play essential roles in control of neurosecretion and muscle contraction. The pharmacological significance of Cav channels stem from their identification as the molecular targets of calcium blockers used in the treatment of cardiovascular diseases, such as hypertension, angina, and arrhythmia, and neurologic diseases, such as pain and seizure. It has been proposed that state-dependent Cav inhibitors, that is, those that preferentially bind to channels in open or inactivated states, may improve the therapeutic window over relatively state-independent Cav inhibitors. High-throughput fluorescent-based functional assays have been useful in screening chemical libraries to identify Cav inhibitors. However, hit confirmation, mechanism of action, and subtype selectivity are better suited to automated patch clamp assays that have sufficient capacity to handle the volume of compounds identified during screening, even of modest sized libraries (≤500,000 compounds), and the flexible voltage control that allows evaluation of state-dependent drug blocks. IonWorks Barracuda (IWB), the newest generation of IonWorks instruments, provides the opportunity to accelerate the Cav drug discovery studies in an automated patch clamp platform in 384-well format capable of medium throughput screening and profiling studies. We have validated hCav1.2, hCav2.1, hCav2.2, and hCav3.2 channels assays on the IWB platform (population patch clamp mode) and demonstrated that the biophysical characteristics of the channels (activation, inactivation, and steady-state inactivation) obtained with the IWB system are consistent with known subtype-specific characteristics. Using standard reference compounds (nifedipine, BAY K8644, verapamil, mibefradil, and pimozide), we demonstrated subtype-selective and state- and use-dependent characteristics of drug-channel interactions. Here we describe the design and validation of novel robust high-throughput Cav channel assays on the IWB

  9. Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review

    OpenAIRE

    Farsalinos, Konstantinos E.; Polosa, Riccardo

    2014-01-01

    Electronic cigarettes are a recent development in tobacco harm reduction. They are marketed as less harmful alternatives to smoking. Awareness and use of these devices has grown exponentially in recent years, with millions of people currently using them. This systematic review appraises existing laboratory and clinical research on the potential risks from electronic cigarette use, compared with the well-established devastating effects of smoking tobacco cigarettes. Currently available evidenc...

  10. Evaluation of digital model accuracy and time-dependent deformation of alginate impressions.

    Science.gov (United States)

    Cesur, M G; Omurlu, I K; Ozer, T

    2017-09-01

    The aim of this study was to evaluate the accuracy of digital models produced with the three-dimensional dental scanner, and to test the dimensional stability of alginate impressions for durations of immediately (T0), 1 day (T1), and 2 days (T2). A total of sixty impressions were taken from a master model with an alginate, and were poured into plaster models in three different storage periods. Twenty impressions were directly scanned (negative digital models), after which plaster models were poured and scanned (positive digital models) immediately. The remaining 40 impressions were poured after 1 and 2 days. In total, 9 points and 11 linear measurements were used to analyze the plaster models, and negative and positive digital models. Time-dependent deformation of the alginate impressions and the accuracy of the conventional plaster models and digital models were evaluated separately. Plaster models, negative and positive digital models showed significant differences in nearly all measurements at T (0), T (1), and T (2) times (P 0.05), but they demonstrated statistically significant differences at T (2) time (P digital models offer a high degree of validity when compared to measurements on positive digital models and plaster models; differences between the techniques are clinically acceptable. Direct scanning of the impressions is practicable method for orthodontists.

  11. Systematic review and metaanalysis of statins for heterozygous familial hypercholesterolemia in children: evaluation of cholesterol changes and side effects.

    LENUS (Irish Health Repository)

    O'Gorman, Clodagh S

    2012-02-01

    Heterozygous familial hypercholesterolemia (heFH) affects 1 in 500 individuals. Evidence supports the low-density lipoprotein (LDL)-lowering effect of statins for adults with heFH. However, there are concerns regarding the treatment children with heFH. By performing a systematic review and metaanalysis of the published literature, this study aimed to evaluate the efficacy and safety of statins used for children with heFH. A systematic review was performed by searching multiple medical databases and citations to identify reports of randomized controlled trials of statins used to treat children with heFH. The trials were retrieved, reviewed, and subjected to metaanalysis. The search yielded 2,174 titles. Of the 63 studies retrieved and reviewed, 56 were excluded, 7 were included in the systematic review, and 4 were included in the metaanalysis. Significant heterogeneity was detected. The metaanalysis showed significant LDL lowering, high-density lipoprotein (HDL) cholesterol elevation, and increases in height and weight with statins. The metaanalysis could not be performed for many side effects of statins, but individual trials showed no significant side effects. Quality assessment showed methodologic concerns, with potential for bias. For example, six trials analyzed statin effects without intention to treat despite such a stated intention. Metaanalysis shows significant LDL lowering with statin treatment. Further studies, including epidemiologic and multicenter studies, are required.

  12. A Decade of Research on Evaluation: A Systematic Review of Research on Evaluation Published between 2005 and 2014

    Science.gov (United States)

    Coryn, Chris L. S.; Wilson, Lyssa N.; Westine, Carl D.; Hobson, Kristin A.; Ozeki, Satoshi; Fiekowsky, Erica L.; Greenman, Gregory D., II; Schröter, Daniela C.

    2017-01-01

    Although investigations into evaluation theories, methods, and practices have been occurring since the late 1970s, research on evaluation (RoE) has seemingly increased in the past decade. In this review, 257 studies published in 14 evaluation-focused journals over a 10-year period (between 2005 and 2014) were identified as RoE and then classified…

  13. Inclusion of the value of herd immunity in economic evaluations of vaccines. A systematic review of methods used

    DEFF Research Database (Denmark)

    Nymark, Liv Solvår; Sharma, T; Miller, A

    2017-01-01

    human-transmissible diseases from 1976 to 2015. Of these, 172 (28%) included herd immunity. While 4% of studies included herd immunity in 2001, 53% of those published in 2015 did this. Pneumococcal, human papilloma and rotavirus vaccines represented the majority of studies (63%) considering herd......OBJECTIVE: The objectives of this review were to identify vaccine economic evaluations that include herd immunity and describe the methodological approaches used. METHODS: We used Kim and Goldie's search strategy from a systematic review (1976-2007) of modelling approaches used in vaccine economic...... evaluations and additionally searched PubMed/MEDLINE and Embase for 2007-2015. Studies were classified according to modelling approach used. Methods for estimating herd immunity effects were described, in particular for the static models. RESULTS: We identified 625 economic evaluations of vaccines against...

  14. The global chemical systematics of arc front stratovolcanoes: Evaluating the role of crustal processes

    Science.gov (United States)

    Turner, Stephen J.; Langmuir, Charles H.

    2015-07-01

    Petrogenetic models for convergent margins should be consistent with the global systematics of convergent margin volcanic compositions. A newly developed tool for compiling and screening data from the GEOROC database was used to generate a global dataset of whole rock chemical analyses from arc front stratovolcano samples. Data from 227 volcanoes within 31 volcanic arc segments were first averaged by volcano and then by arc to explore global systematics. Three different methods of data normalization produce consistent results that persist across a wide range of Mg# [Mg# =Mg / (Mg +Fe) ]. Remarkably coherent systematics are present among major and trace element concentrations and ratios, with the exception of three arcs influenced by mantle plumes and Peru/N. Chile, which is built on exceptionally thick crust. Chemical parameters also correlate with the thickness of the overlying arc crust. In addition to previously established correlations of Na6.0 with Ca6.0 and crustal thickness, correlations are observed among major elements, trace elements, and trace element ratios (e.g. La/Yb, Dy/Yb, Zr/Sm, Zr/Ti). Positive correlations include "fluid mobile," "high field strength," and "large ion lithophile" element groups, with concentrations that vary by a factor of five in all groups. Incompatible element enrichments also correlate well with crustal thickness, with the greatest enrichment found at arcs with the thickest crust. Intra-crustal processes, however, do not reproduce the global variations. High pressure fractionation produces intermediate magmas enriched in aluminum, but such magmas are rare. Furthermore, differences among magma compositions at various volcanic arcs persist from primitive to evolved compositions, which is inconsistent with the possibility that global variations are produced by crystal fractionation at any pressure. Linear relationships among elements appear to be consistent with mixing between depleted primary magma and an enriched contaminant

  15. Evaluation of clinical experience using cell-based therapies in patients with spinal cord injury: a systematic review.

    Science.gov (United States)

    Harrop, James S; Hashimoto, Robin; Norvell, Dan; Raich, Annie; Aarabi, Bizhan; Grossman, Robert G; Guest, James D; Tator, Charles H; Chapman, Jens; Fehlings, Michael G

    2012-09-01

    Using a systematic approach, the authors evaluated the current utilization, safety, and effectiveness of cellular therapies for traumatic spinal cord injuries (SCIs) in humans. A systematic search and critical review of the literature published through mid-January 2012 was performed. Articles included in the search were restricted to the English language, studies with at least 10 patients, and those analyzing cellular therapies for traumatic SCI. Citations were evaluated for relevance using a priori criteria, and those that met the inclusion criteria were critically reviewed. Each article was then designated a level of evidence that was developed by the Oxford Centre for Evidence-Based Medicine. The initial literature search identified 651 relevant articles, which decreased to 350 after excluding case reports and reviews. Evaluation of articles at the title/abstract level, and later at the full-text level, limited the final article set to 12 papers. The following cellular therapies employed in humans with SCI are reviewed: bone marrow mesenchymal and hematopoietic stem cells (8 studies), olfactory ensheathing cells (2 studies), Schwann cells (1 study), and fetal neurogenic tissue (1 study). Overall the quality of the literature was very low, with 3 Grade III levels of evidence and 9 Grade IV studies. Several different cellular-mediated strategies for adult SCI have been reported to be relatively safe with varying degrees of neurological recovery. However, the literature is of low quality and there is a need for improved preclinical studies and prospective, controlled clinical trials.

  16. An evaluation of a model for the systematic documentation of hospital based health promotion activities: results from a multicentre study

    DEFF Research Database (Denmark)

    Tønnesen, Hanne; Christensen, Mette E; Groene, Oliver

    2007-01-01

    of two parts; first part includes motivational counselling (7 codes) and the second part comprehends intervention, rehabilitation and after treatment (8 codes).The objective was to evaluate in an international study the usefulness, applicability and sufficiency of a simple model for the systematic...... and in patient administrative systems have been sparse. Therefore, the activities are mostly invisible in the registers of hospital services as well as in budgets and balances.A simple model has been described to structure the registration of the HP procedures performed by the clinical staff. The model consists...

  17. Evaluation of the energy dependence of a zinc oxide nanofilm X-ray detector

    Energy Technology Data Exchange (ETDEWEB)

    Valenca, C.P.V., E-mail: claudia.cpvv@gmail.com [Universidade Federal de Pernambuco (UFPE), Recife (Brazil); Silveira, M.A.L.; Macedo, M.A., E-mail: odecamm@gmail.com [Universidade Federal de Sergipe (UFSE), Sao Cristovao, SE (Brazil); Santos, L.A.P, E-mail: lasantos@scients.com.br [Centro Regional de Ciencias Nucleares (CRCN-NE/CNEN-PE), Recife, PE (Brazil)

    2015-07-01

    International organizations of human health and radiation protection have recommended certain care for using of the X-ray as a diagnosis tool to avoid any type of radiological accident or overdose to the patient. This can be done assessing the parameters of the X-ray equipment and there are various types of detectors available for that: ionizing chamber, electronic semiconductor devices, etc. These detectors must be calibrated so that they can be used for any energy range and such a procedure is correlated with what is called the energy dependence of the detector. In accordance with the stated requirements of IEC 61267, the standard radiation quality beams and irradiation conditions (RQRs) are the tools and techniques for calibrating diagnostic X-Ray instruments and detectors. The purpose of this work is to evaluate the behavior of the energy dependence of a detector fabricated from a zinc oxide (ZnO) nanofilm. A Pantak industrial X-ray equipment was used to generate the RQR radiation quality beams and test three ZnO detector samples. A 6430 sub-femto-ammeter, Keithley, was used to bias the ZnO detector and simultaneously perform the output readings. The results showed that the ZnO device has some increase in its sensitivity to the ionizing radiation as the X-ray effective energy decreases unlike other types of semiconductor electronic devices typically used as an X-ray detector. We can conclude that the ZnO device can be used as a diagnostic X-ray detector with an appropriate calibration. (author)

  18. An iterative evaluation of two shortened systematic review formats for clinicians: a focus group study.

    Science.gov (United States)

    Perrier, Laure; Kealey, M Ryan; Straus, Sharon E

    2014-10-01

    To conduct a series of focus groups with primary care physicians to determine the optimal format of a shortened, focused systematic review. Prototypes for two formats of a shortened systematic review were developed and presented to participants during focus group sessions. Focus groups were conducted with primary care physicians who were in full- or part-time practice. An iterative process was used so that the information learned from the first set of focus groups (Round 1) influenced the material presented to the second set of focus groups (Round 2). The focus group discussions were recorded, transcribed verbatim, and analyzed. Each of the two rounds of testing included three focus groups. A total of 32 physicians participated (Round 1:16 participants; Round 2:16 participants). Analysis of the transcripts from Round 1 identified three themes including ease of use, clarity, and implementation. Changes were made to the prototypes based on the results so that the revised prototypes could be presented and discussed in the second round of focus groups. After analysis of transcripts from Round 2, four themes were identified, including ease of use, clarity, brevity, and implementation. Revisions were made to the prototypes based on the results. Primary care physicians provided input on the refinement of two prototypes of a shortened systematic review for clinicians. Their feedback guided changes to the format, presentation, and layout of these prototypes in order to increase usability and uptake for end-users. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. A Systematic Review and Critical Appraisal of Economic Evaluations of Pharmacological Interventions for People with Bipolar Disorder.

    Science.gov (United States)

    Mavranezouli, Ifigeneia; Lokkerbol, Joran

    2017-03-01

    Bipolar disorder (BD) is a chronic mood disorder that causes substantial psychological and financial burden. Various pharmacological treatments are effective in the management and prevention of acute episodes of BD. In an era of tighter healthcare budgets and a need for more efficient use of resources, several economic evaluations have evaluated the cost effectiveness of treatments for BD. The aim of this study was to systematically review and appraise published economic evaluations of pharmacological interventions for BD. A systematic search combining search terms specific to BD with a health economics search filter was conducted on six bibliographic databases (EMBASE, MEDLINE, PsycINFO, HTA, NHS EED, CENTRAL) in order to identify trial- or model-based full economic evaluations of pharmacological treatments of any phase of the disorder that were published between 1 January 1990 and 18 December 2015. Studies that met the inclusion criteria were critically appraised using the Quality of Health Economic Studies (QHES) checklist, and synthesised in a narrative way. The review included 19 economic studies, which varied with regard to the type and number of interventions assessed, the study design, the phase of treatment (acute or maintenance), the source of efficacy data and the method for evidence synthesis, the outcome measures, the time horizon and the countries/settings in which the studies were conducted. The study quality was variable but the majority of studies were of high or fair quality. Pharmacological interventions are cost effective, compared with no treatment, in the management of BD, both in the acute and maintenance phases. However, it is difficult to draw safe conclusions on the relative cost effectiveness between drugs due to differences across studies and limitations characterising many of them. Future economic evaluations need to consider the whole range of treatment options available for the management of BD and adopt appropriate methods for

  20. Evaluating Web-Based Nursing Education's Effects: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Kang, Jiwon; Seomun, GyeongAe

    2017-09-01

    This systematic review and meta-analysis investigated whether using web-based nursing educational programs increases a participant's knowledge and clinical performance. We performed a meta-analysis of studies published between January 2000 and July 2016 and identified through RISS, CINAHL, ProQuest Central, Embase, the Cochrane Library, and PubMed. Eleven studies were eligible for inclusion in this analysis. The results of the meta-analysis demonstrated significant differences not only for the overall effect but also specifically for blended programs and short (2 weeks or 4 weeks) intervention periods. To present more evidence supporting the effectiveness of web-based nursing educational programs, further research is warranted.

  1. The methodological quality of economic evaluation studies in obstetrics and gynecology: a systematic review

    NARCIS (Netherlands)

    Vijgen, Sylvia M. C.; Opmeer, Brent C.; Mol, Ben Willem J.

    2013-01-01

    We evaluated the methodological quality of economic evaluation studies in the field of obstetrics and gynecology published in the last decade. A MEDLINE search was performed to find economic evaluation studies in obstetrics and gynecology from the years 1997 through 2009. We included full economic

  2. Systematic Reviews and Meta-Analyses - Literature-based Recommendations for Evaluating Strengths, Weaknesses, and Clinical Value.

    Science.gov (United States)

    Beitz, Janice M; Bolton, Laura L

    2015-11-01

    Good quality systematic reviews (SRs) summarizing best available evidence can help inform clinical decisions, improv- ing patient and wound outcomes. Weak SRs can misinform readers, undermining care decisions and evidence-based practice. To examine the strengths and weaknesses of SRs and meta-analyses and the role of SRs in contemporary evidence-based wound care practice, and using the search terms systematic review, meta-analysis, and evidence-based practice, the authors searched Medline and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) for important terminology and recommendations to help clinicians evaluate SRs with meta-analysis. Reputable websites, recent textbooks, and synthesized available literature also were reviewed to describe and summarize SR strengths and weaknesses. After developing a checklist for critically evaluating SR objectives, inclusion/exclusion criteria, study quality, data extraction and synthesis methods, meta-analysis homogeneity, accuracy of results, interpretation, and consistency between significant findings and abstract or conclusions, the checklist was applied to topical wound care SRs identified in Cochrane and MEDLINE searches. Best available evidence included in the SRs from 169 randomized controlled trials on 11,571 patients supporting topical intervention healing effects on burns, surgical sites, and diabetic, venous, or pressure ulcers was summarized and showed SRs and clinical trials can demonstrate different outcomes because the information/data are compiled differently. The results illustrate how evidence insufficient to support firm conclusions may still meet immediate needs to guide carefully considered clinical wound and patient care decisions while encouraging better future science.

  3. A systematic evaluation of chemicals in hydraulic-fracturing fluids and wastewater for reproductive and developmental toxicity.

    Science.gov (United States)

    Elliott, Elise G; Ettinger, Adrienne S; Leaderer, Brian P; Bracken, Michael B; Deziel, Nicole C

    2017-01-01

    Hydraulic-fracturing fluids and wastewater from unconventional oil and natural gas development contain hundreds of substances with the potential to contaminate drinking water. Challenges to conducting well-designed human exposure and health studies include limited information about likely etiologic agents. We systematically evaluated 1021 chemicals identified in hydraulic-fracturing fluids (n=925), wastewater (n=132), or both (n=36) for potential reproductive and developmental toxicity to triage those with potential for human health impact. We searched the REPROTOX database using Chemical Abstract Service registry numbers for chemicals with available data and evaluated the evidence for adverse reproductive and developmental effects. Next, we determined which chemicals linked to reproductive or developmental toxicity had water quality standards or guidelines. Toxicity information was lacking for 781 (76%) chemicals. Of the remaining 240 substances, evidence suggested reproductive toxicity for 103 (43%), developmental toxicity for 95 (40%), and both for 41 (17%). Of these 157 chemicals, 67 had or were proposed for a federal water quality standard or guideline. Our systematic screening approach identified a list of 67 hydraulic fracturing-related candidate analytes based on known or suspected toxicity. Incorporation of data on potency, physicochemical properties, and environmental concentrations could further prioritize these substances for future drinking water exposure assessments or reproductive and developmental health studies.

  4. Evaluation of Mechanical Strength of Five Layered Corrugated Cardboard Depending on the Types of Waveforms

    Directory of Open Access Journals (Sweden)

    Ivan Budimir

    2013-01-01

    Full Text Available Due to the growing need for material saving in the production of paper packaging, its industrial production is faced with the problem of quality assurance. By controlling the cost of production of corrugated cardboard, paperboard mechanical properties depend directly on the flute profile. Therefore, the corrugated cardboard can be observed both from technological and environmental aspects. Five layered corrugated cardboard of different types of flute profile was used for this research. It is assumed that the characteristic shape of the wave has a positive effect on its mechanical properties. On the other hand, it is supposed if the material saving can be achieved without the characteristic flute profile effects on the reduction of mechanical strength of paperboard. The aim of the research is to determine whether there is a direct impact on the type of waveform on its mechanical strength. Statistical methods were used for the evaluation of expectation values ​​of the estimated strength of corrugated board with respect to the flute profile.

  5. Evaluation of Mechanical Strength of Five Layered Corrugated Cardboard Depending on the Types of Waveforms

    Directory of Open Access Journals (Sweden)

    Ivan Budimir

    2012-12-01

    Full Text Available Due to the growing need for material saving in the production of paper packaging, its industrial production is faced with the problem of quality assurance. By controlling the cost of production of corrugated cardboard, paperboard mechanical properties depend directly on the flute profile. Therefore, the corrugated cardboard can be observed both from technological and environmental aspects.Five layered corrugated cardboard of different types of flute profile was used for this research. It is assumed that the characteristic shape of the wave has a positive effect on its mechanical properties. On the other hand, it is supposed if the material saving can be achieved without the characteristic flute profile effects on the reduction of mechanical strength of paperboard. The aim of the research is to determine whether there is a direct impact on the type of waveform on its mechanical strength. Statistical methods were used for the evaluation of expectation values ​​of the estimated strength of corrugated board with respect to the flute profile.

  6. Systematic review of physical fitness testing to evaluate the physical combat readiness of Royal Thai Armed Forces.

    Science.gov (United States)

    Panichkul, Suthee; Hatthachote, Panadda; Napradit, Phunphen; Khunphasee, Arom; Nathalang, Oytip

    2007-12-01

    Physical combat readiness of military personnel ensures maximal effectiveness of combat forces during wartime. Combat readiness has always been linked to the Army Physical Fitness Test (APFT). Each raw score is converted to a standard score and corrected for age and gender. There is no standard measurement to evaluate combat readiness in the Royal Thai Army. To determine standardized criteria for physical combat readiness of Royal Thai Army personnel through systematic review, the APFT was used to determine fitness levels and to promote health. To pass the test, each soldier in each unit must attain a minimal standard score for each individual subtest. At present, each unit in the armed forces derives its own standard, based on different missions. The APFT might be an acceptable method to measure physical combat readiness. However, no studies have established the general measurements to evaluate combat readiness.

  7. Systematic review of educational interventions for looked-after children and young people: Recommendations for intervention development and evaluation.

    Science.gov (United States)

    Evans, Rhiannon; Brown, Rachel; Rees, Gwyther; Smith, Philip

    2017-02-01

    Looked-after children and young people (LACYP) are educationally disadvantaged compared to the general population. A systematic review was conducted of randomised controlled trials evaluating interventions aimed at LACYP aged ≤18 years. Restrictions were not placed on delivery setting or delivery agent. Intervention outcomes were: academic skills; academic achievement and grade completion; special education status; homework completion; school attendance, suspension, and drop-out; number of school placements; teacher-student relationships; school behaviour; and academic attitudes. Fifteen studies reporting on 12 interventions met the inclusion criteria. Nine interventions demonstrated tentative impacts. However, evidence of effectiveness could not be ascertained due to variable methodological quality, as appraised by the Cochrane risk of bias tool. Theoretical and methodological recommendations are provided to enhance the development and evaluation of educational interventions.

  8. Evaluation Criteria of Noninvasive Telemonitoring for Patients With Heart Failure: Systematic Review.

    Science.gov (United States)

    Farnia, Troskah; Jaulent, Marie-Christine; Steichen, Olivier

    2018-01-16

    Telemonitoring can improve heart failure (HF) management, but there is no standardized evaluation framework to comprehensively evaluate its impact. Our objectives were to list the criteria used in published evaluations of noninvasive HF telemonitoring projects, describe how they are used in the evaluation studies, and organize them into a consistent scheme. Articles published from January 1990 to August 2015 were obtained through MEDLINE, Web of Science, and EMBASE. Articles were eligible if they were original reports of a noninvasive HF telemonitoring evaluation study in the English language. Studies of implantable telemonitoring devices were excluded. Each selected article was screened to extract the description of the telemonitoring project and the evaluation process and criteria. A qualitative synthesis was performed. We identified and reviewed 128 articles leading to 52 evaluation criteria classified into 6 dimensions: clinical, economic, user perspective, educational, organizational, and technical. The clinical and economic impacts were evaluated in more than 70% of studies, whereas the educational, organizational, and technical impacts were studied in fewer than 15%. User perspective was the most frequently covered dimension in the development phase of telemonitoring projects, whereas clinical and economic impacts were the focus of later phases. Telemonitoring evaluation frameworks should cover all 6 dimensions appropriately distributed along the telemonitoring project lifecycle. Our next goal is to build such a comprehensive evaluation framework for telemonitoring and test it on an ongoing noninvasive HF telemonitoring project.

  9. Economic Evaluations of Multicomponent Disease Management Programs with Markov Models: A Systematic Review.

    Science.gov (United States)

    Kirsch, Florian

    2016-12-01

    Disease management programs (DMPs) for chronic diseases are being increasingly implemented worldwide. To present a systematic overview of the economic effects of DMPs with Markov models. The quality of the models is assessed, the method by which the DMP intervention is incorporated into the model is examined, and the differences in the structure and data used in the models are considered. A literature search was conducted; the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed to ensure systematic selection of the articles. Study characteristics e.g. results, the intensity of the DMP and usual care, model design, time horizon, discount rates, utility measures, and cost-of-illness were extracted from the reviewed studies. Model quality was assessed by two researchers with two different appraisals: one proposed by Philips et al. (Good practice guidelines for decision-analytic modelling in health technology assessment: a review and consolidation of quality asessment. Pharmacoeconomics 2006;24:355-71) and the other proposed by Caro et al. (Questionnaire to assess relevance and credibility of modeling studies for informing health care decision making: an ISPOR-AMCP-NPC Good Practice Task Force report. Value Health 2014;17:174-82). A total of 16 studies (9 on chronic heart disease, 2 on asthma, and 5 on diabetes) met the inclusion criteria. Five studies reported cost savings and 11 studies reported additional costs. In the quality, the overall score of the models ranged from 39% to 65%, it ranged from 34% to 52%. Eleven models integrated effectiveness derived from a clinical trial or a meta-analysis of complete DMPs and only five models combined intervention effects from different sources into a DMP. The main limitations of the models are bad reporting practice and the variation in the selection of input parameters. Eleven of the 14 studies reported cost-effectiveness results of less than $30,000 per quality-adjusted life-year and

  10. Effectiveness and Economic Evaluation of Chiropractic Care for the Treatment of Low Back Pain: A Systematic Review of Pragmatic Studies

    Science.gov (United States)

    Blanchette, Marc-André; Stochkendahl, Mette Jensen; Borges Da Silva, Roxane; Boruff, Jill; Harrison, Pamela; Bussières, André

    2016-01-01

    Background Context Low back pain (LBP) is one of the leading causes of disability worldwide and among the most common reasons for seeking primary sector care. Chiropractors, physical therapists and general practitioners are among those providers that treat LBP patients, but there is only limited evidence regarding the effectiveness and economic evaluation of care offered by these provider groups. Purpose To estimate the clinical effectiveness and to systematically review the literature of full economic evaluation of chiropractic care compared to other commonly used care approaches among adult patients with non-specific LBP. Study Design Systematic reviews of interventions and economic evaluations. Methods A comprehensive search strategy was conducted to identify 1) pragmatic randomized controlled trials (RCTs) and/or 2) full economic evaluations of chiropractic care for low back pain compared to standard care delivered by other healthcare providers. Studies published between 1990 and 4th June 2015 were considered. Primary outcomes included pain, functional status and global improvement. Study selection, critical quality appraisal and data extraction were conducted by two independent reviewers. Data from RCTs with low risk of bias were included in a meta-analysis to determine effect estimates. Cost estimates of full economic evaluations were converted to 2015 USD and results summarized using Slavin’s qualitative best-evidence synthesis. Results Six RCTs and three full economic evaluations were scientifically admissible. Five RCTs with low risk of bias compared chiropractic care to exercise therapy (n = 1), physical therapy (n = 3) and medical care (n = 1). Overall, we found similar effects for chiropractic care and the other types of care and no reports of serious adverse events. Three low to high quality full economic evaluations studies (one cost-effectiveness, one cost-minimization and one cost-benefit) compared chiropractic to medical care. Given the divergent

  11. Evaluation of the Effects of Radio-Frequency Identification Technology on Patient Tracking in Hospitals: A Systematic Review.

    Science.gov (United States)

    Ebrahimzadeh, Fahimeh; Nabovati, Ehsan; Hasibian, Mohammad Reza; Eslami, Saeid

    2017-12-15

    The aim of this study was to systematically review all studies that evaluated the effects of using radio-frequency identification (RFID) for tracking patients in hospitals. The PubMed and Embase databases were searched (to August 2015) for relevant English language studies, and those that evaluated the effects of a real-time locating systems with RFID for patient tracking in hospitals were identified and extracted. Of the 652 studies found, the 17 relevant studies were extracted for inclusion. Five of the extracted studies used RFID systems in operating theaters, two in emergency departments, one in a magnetic resonance imaging department, one in a radiology room, and the remaining eight studies were in other wards. In these studies, features such as the feasibility, accuracy, precision, reliability, security, level of satisfaction, cost of care, and time efficiency of the RFID systems were reported. Of all the extracted studies, seven evaluated the accuracy of the systems in crowded and unattended areas, and five of these were satisfied with their accuracy. Six evaluated the reliability of the systems, and all of these found the systems to be reliable. Six evaluated time-savings, and all of them reported the systems to be time effective. Two focused on the cost of care, and both of these reported the systems to be cost effective. Although most studies reported a positive impact on the accuracy and precision of patient identification, there is insufficient good evidence to show that RFID systems can accurately localize patients in crowded settings.

  12. Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: A practical review for clinical researchers-Part I. general guidance and tips

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Won; Choi, Sang Hyun; Huh, Jimi; Park, Seong Ho [Dept. of Radiology, and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Lee, June Young [Dept. of Biostatistics, Korea University College of Medicine, Seoul (Korea, Republic of)

    2015-12-15

    In the field of diagnostic test accuracy (DTA), the use of systematic review and meta-analyses is steadily increasing. By means of objective evaluation of all available primary studies, these two processes generate an evidence-based systematic summary regarding a specific research topic. The methodology for systematic review and meta-analysis in DTA studies differs from that in therapeutic/interventional studies, and its content is still evolving. Here we review the overall process from a practical standpoint, which may serve as a reference for those who implement these methods.

  13. Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, Birgit; Lund, Hans

    2014-01-01

    ; (2) validity; and (3) responsiveness. Observational evaluation systems and assessment of scapular upward rotation seem suitably evidence-based for clinical use. Future studies should test and improve the clinimetric properties, and especially diagnostic accuracy and responsiveness, to increase...... excluded for evaluation due to no/few clinimetric results, leaving 35 studies for evaluation. Graded according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN checklist), the methodological quality in the reliability and validity domains was "fair" (57...

  14. Health economic evaluation in lumbar spinal fusion: a systematic literature review anno 2005

    DEFF Research Database (Denmark)

    Soegaard, Rikke; Christensen, Finn B

    2006-01-01

    The goal of this systematic literature review was to assess the evidence for cost-effectiveness of various surgical techniques in lumbar spinal fusion in conformity with the guidelines provided by the Cochrane Back Review Group. As new technology continuously emerges and divergent directions...... of quality assessment, the methodological quality of three studies was judged credible. Two studies investigated posteolateral fusion (PLF) +/- instrumentation in different populations: one investigated non-specific low back pain and one investigated degenerative stenosis + spondylolisthesis. Both studies...... reflected that cost-effectiveness of instrumentation in PLF is not convincing. The third study concerned the question of circumferential vs anterior lumbar interbody fusion and found a non-significant difference between the techniques. In conclusion, the literature is limited and, in view of the fact...

  15. Systematic evaluation of genes and genetic variants associated with type 1 diabetes susceptibility

    DEFF Research Database (Denmark)

    Ram, Ramesh; Mehta, Munish; Nguyen, Tri Quang

    2016-01-01

    Genome-wide association studies have found >60 loci that confer genetic susceptibility to type 1 diabetes (T1D). Many of these are defined only by anonymous single nucleotide polymorphisms: the underlying causative genes, as well as the molecular bases by which they mediate susceptibility...... cell type. Additionally, we observed 25 loci that affected 38 transcripts in trans. In summary, our systems genetics analyses defined the effect of T1D risk alleles on levels of gene expression and provide novel insights into the complex genetics of T1D, suggesting that most of the T1D risk alleles......, are not known. Identification of how these variants affect the complex mechanisms contributing to the loss of tolerance is a challenge. In this study, we performed systematic analyses to characterize these variants. First, all known genes in strong linkage disequilibrium (r2 > 0.8) with the reported single...

  16. Systematic evaluation and description of anal pathology in HIV-infected patients during the HAART era.

    Science.gov (United States)

    Abramowitz, Laurent; Benabderrahmane, Dalila; Baron, Gabriel; Walker, Francine; Yeni, Patrick; Duval, Xavier

    2009-06-01

    This study aimed to determine the prevalence of macroscopic anal lesions and associated factors in HIV-infected outpatients during the era of highly active antiretroviral therapy. A randomly selected sample of patients with HIV-infection receiving follow-up care in the infectious diseases department of Bichat University Hospital was invited to participate in a systematic screening program consisting of anal examination with anoscopy and a standardized questionnaire. Of 516 patients, 473 (92 percent) participated. Overall, 208 patients (44 percent) had at least one anal macroscopic lesion: 108 patients (22.8 percent) had human papilloma (HPV)-related lesions (condyloma with or without dysplasia), 67 (14.2 percent) had hemorrhoidal disease, 50 (10.6 percent) had anal fissures, and 44 (9.3) percent had other anal lesions. Independent significantly associated factors for anal condyloma were history of anal condyloma (OR, 2.09) and median number of episodes of sexual intercourse per month (OR, 1.03) in men who have sex with men; history of genital condyloma (OR, 26.74), and unprotected sexual intercourse (OR, 7.47) in heterosexual men; and CD4 cell count below 200/mm3 (OR, 6.02), receptive anal intercourse (OR, 6.37), and history of anal condyloma (OR, 16.69) in women. Neither sexual behavior nor characteristics related to HIV infection were associated with hemorrhoidal disease or anal fissure. Because patients with HIV infections have a high prevalence of unreported anal lesions that may be highly contagious, involve risk of anal neoplasia, or negatively affect quality of life, systematic anal screening should be conducted in the HIV-infected population.

  17. Economic Evaluation of Community Water Fluoridation: A Community Guide Systematic Review.

    Science.gov (United States)

    Ran, Tao; Chattopadhyay, Sajal K

    2016-06-01

    A recently updated Community Guide systematic review of the effectiveness of community water fluoridation once again found evidence that it reduces dental caries. Although community water fluoridation was found to save money in a 2002 Community Guide systematic review, the conclusion was based on studies conducted before 1995. Given the update to the effectiveness review, re-examination of the benefit and cost of community water fluoridation is necessary. Using methods developed for Community Guide economic reviews, 564 studies were identified within a search period from January 1995 to November 2013. Ten studies were included in the current review, with four covering community fluoridation benefits only and another six providing both cost and benefit information. Additionally, two of the six studies analyzed the cost effectiveness of community water fluoridation. All currencies were converted to 2013 dollars. The analysis was conducted in 2014. The benefit-only studies used regression analysis, showing that different measures of dental costs were always lower in communities with water fluoridation. For the six cost-benefit studies, per capita annual intervention cost ranged from $0.11 to $4.92 for communities with at least 1,000 population, and per capita annual benefit ranged from $5.49 to $93.19. Benefit-cost ratios ranged from 1.12:1 to 135:1, and these ratios were positively associated with community population size. Recent evidence continues to indicate that the economic benefit of community water fluoridation exceeds the intervention cost. Further, the benefit-cost ratio increases with the community population size. Published by Elsevier Inc.

  18. Sources and Characteristics of Utility Weights for Economic Evaluation of Pediatric Vaccines: A Systematic Review.

    Science.gov (United States)

    Herdman, Michael; Cole, Amanda; Hoyle, Christopher K; Coles, Victoria; Carroll, Stuart; Devlin, Nancy

    2016-01-01

    Cost-effectiveness analysis of pediatric vaccines for infectious diseases often requires quality-of-life (utility) weights. To investigate how utility weights have been elicited and used in this context. A systematic review was conducted of studies published between January 1990 and July 2013 that elicited or used utility weights in cost-effectiveness analyses of vaccines for pediatric populations. The review focused on vaccines for 17 infectious diseases and is presented following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. A total of 6410 titles and abstracts and 225 full-text articles were reviewed. Of those selected for inclusion (n = 101), 15 articles described the elicitation of utility weights and 86 described economic modeling studies using utilities. Various methods were used to generate utilities, including time trade-off, contingent valuation, and willingness to pay, as well as a preference-based measure with associated value sets, such as the EuroQol five-dimensional questionnaire or the Health Utilities Index. In modeling studies, the source of utilities used was often unclear, poorly reported, or based on weak underlying evidence. We found no articles that reported on the elicitation or use of utilities in diphtheria, polio, or tetanus. The scarcity of appropriate utility weights for vaccine-preventable infectious diseases in children and a lack of standardization in their use in economic assessments limit the ability to accurately assess the benefits associated with interventions to prevent infectious diseases. This is an issue that should be of concern to those making decisions regarding the prevention and treatment of infectious childhood illnesses. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  19. A systematic investigation of the protein kinases involved in NMDA receptor-dependent LTD: evidence for a role of GSK-3 but not other serine/threonine kinases

    Directory of Open Access Journals (Sweden)

    Peineau Stéphane

    2009-07-01

    Full Text Available Abstract Background The signalling mechanisms involved in the induction of N-methyl-D-aspartate (NMDA receptor-dependent long-term depression (LTD in the hippocampus are poorly understood. Numerous studies have presented evidence both for and against a variety of second messengers systems being involved in LTD induction. Here we provide the first systematic investigation of the involvement of serine/threonine (ser/thr protein kinases in NMDAR-LTD, using whole-cell recordings from CA1 pyramidal neurons. Results Using a panel of 23 inhibitors individually loaded into the recorded neurons, we can discount the involvement of at least 57 kinases, including PKA, PKC, CaMKII, p38 MAPK and DYRK1A. However, we have been able to confirm a role for the ser/thr protein kinase, glycogen synthase kinase 3 (GSK-3. Conclusion The present study is the first to investigate the role of 58 ser/thr protein kinases in LTD in the same study. Of these 58 protein kinases, we have found evidence for the involvement of only one, GSK-3, in LTD.

  20. SYSTEMATIC INSPECTION METHOD OF UNIVERSAL USABILITY IN ARCHITECTURE: CASE STUDY WITH MODIFIED HEURISTIC EVALUATION

    Directory of Open Access Journals (Sweden)

    Lucy Ana Vilela Staut

    2017-11-01

    Full Text Available This article presents the results of a case study evaluated through modified heuristics-based method in conformation to the Universal Design principles, in a Planned Commercial Center. The main objective is to analyze the application potential of the modified heuristic evaluation as a universal usability inspection method allied to the pluralistic method of inspection. The evaluation is composed of three subsequent sessions: (1 pre-interview, in which five expert interdisciplinary evaluators analyze the Planned Commercial Center’s architectonic projects concerning the Universal Design principles and spatial accessibility and fill out a structured interview form; (2 activities in settings, in which each expert answers the form again during the development of pre-defined activities; and (3 post-interview, in which the forms were once again answered through a reanalysis of the architectonic projects. As result, it was identified that the modified heuristic evaluation can instate effectively the project evaluation before the fact and in the post-occupation evaluation, providing interaction between the architectonic project analysis and the space use. Therefore, further studies on universal usability and its use in inclusive spaces are of paramount importance. This research presented itself as an initial step for the universal usability evaluation in architecture, and recommends applied tests to the architectonic context, because they highlight the importance of interdependent elements analysis inside the constructed environment, and must be implemented to the universal project process.

  1. Using a Systematic Conceptual Model for a Process Evaluation of a Middle School Obesity Risk-Reduction Nutrition Curriculum Intervention: "Choice, Control & Change"

    Science.gov (United States)

    Lee, Heewon; Contento, Isobel R.; Koch, Pamela

    2013-01-01

    Objective: To use and review a conceptual model of process evaluation and to examine the implementation of a nutrition education curriculum, "Choice, Control & Change", designed to promote dietary and physical activity behaviors that reduce obesity risk. Design: A process evaluation study based on a systematic conceptual model. Setting: Five…

  2. Economic evaluation of manual therapy for musculoskeletal diseases: a protocol for a systematic review and narrative synthesis of evidence.

    Science.gov (United States)

    Kim, Chang-Gon; Mun, Su-Jeong; Kim, Ka-Na; Shin, Byung-Cheul; Kim, Nam-Kwen; Lee, Dong-Hyo; Lee, Jung-Han

    2016-05-13

    Manual therapy is the non-surgical conservative management of musculoskeletal disorders using the practitioner's hands on the patient's body for diagnosing and treating disease. The aim of this study is to systematically review trial-based economic evaluations of manual therapy relative to other interventions used for the management of musculoskeletal diseases. Randomised clinical trials (RCTs) on the economic evaluation of manual therapy for musculoskeletal diseases will be included in the review. The following databases will be searched from their inception: Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Econlit, Mantis, Index to Chiropractic Literature, Science Citation Index, Social Science Citation Index, Allied and Complementary Medicine Database (AMED), Cochrane Database of Systematic Reviews (CDSR), National Health Service Database of Abstracts of Reviews of Effects (NHS DARE), National Health Service Health Technology Assessment Database (NHS HTA), National Health Service Economic Evaluation Database (NHS EED), CENTRAL, five Korean medical databases (Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Service System (RISS), DBPIA, Korean Traditional Knowledge Portal (KTKP) and KoreaMed) and three Chinese databases (China National Knowledge Infrastructure (CNKI), VIP and Wanfang). The evidence for the cost-effectiveness, cost-utility and cost-benefit of manual therapy for musculoskeletal diseases will be assessed as the primary outcome. Health-related quality of life and adverse effects will be assessed as secondary outcomes. We will critically appraise the included studies using the Cochrane risk of bias tool and the Drummond checklist. Results will be summarised using Slavin's qualitative best-evidence synthesis approach. The results of the study will be disseminated via a peer-reviewed journal and/or conference presentations

  3. Evaluation of measures of upper limb functioning and disability in people with Parkinson disease: a systematic review.

    Science.gov (United States)

    Proud, Elizabeth L; Miller, Kimberly J; Bilney, Belinda; Balachandran, Sulakshana; McGinley, Jennifer L; Morris, Meg E

    2015-03-01

    To identify measurement tools used for upper limb evaluation in people with Parkinson disease (PD), to summarize the content of each tool using the International Classification of Functioning, Disability and Health, and to examine the reliability, validity, clinical utility, and responsiveness of the measurement tools specific to this clinical group. Two systematic searches of online databases included articles published from inception to November 2013. Search 1 identified upper limb measures. Search 2 retrieved studies investigating the measurement properties of these tools in people with PD. Independent reviewers screened articles and extracted data, classified measurement tool content on the basis of the International Classification of Functioning, Disability and Health content domains, and applied both the COnsensus-based Standards for the selection of health status Measurement INstruments checklist to evaluate the study's methodological quality and a second checklist by Terwee et al to assess the measurement tool's quality. A third reviewer adjudicated differences between reviewers. Information on clinical utility was also compiled. The 18 identified measures included PD-specific scales, generic measures, and tools developed for other clinical populations; most measures evaluated impairments and/or activity limitations. Measurement properties of 10 of the 18 identified measures were evaluated in people with PD. No high-quality studies investigated validity or responsiveness. High-quality evidence supported the interrater reliability of some Unified Parkinson's Disease Rating Scale subtests, and lower quality studies provided limited evidence for the test-retest reliability of measures evaluating fine hand function and bradykinesia. There are relatively few high-quality studies to support the measurement properties, particularly the validity and responsiveness, of tools currently used to evaluate upper limb disability and function in people with PD. Further

  4. Model-based economic evaluations in smoking cessation and their transferability to new contexts: a systematic review.

    Science.gov (United States)

    Berg, Marrit L; Cheung, Kei Long; Hiligsmann, Mickaël; Evers, Silvia; de Kinderen, Reina J A; Kulchaitanaroaj, Puttarin; Pokhrel, Subhash

    2017-06-01

    To identify different types of models used in economic evaluations of smoking cessation, analyse the quality of the included models examining their attributes and ascertain their transferability to a new context. A systematic review of the literature on the economic evaluation of smoking cessation interventions published between 1996 and April 2015, identified via Medline, EMBASE, National Health Service (NHS) Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA). The checklist-based quality of the included studies and transferability scores was based on the European Network of Health Economic Evaluation Databases (EURONHEED) criteria. Studies that were not in smoking cessation, not original research, not a model-based economic evaluation, that did not consider adult population and not from a high-income country were excluded. Among the 64 economic evaluations included in the review, the state-transition Markov model was the most frequently used method (n = 30/64), with quality adjusted life years (QALY) being the most frequently used outcome measure in a life-time horizon. A small number of the included studies (13 of 64) were eligible for EURONHEED transferability checklist. The overall transferability scores ranged from 0.50 to 0.97, with an average score of 0.75. The average score per section was 0.69 (range = 0.35-0.92). The relative transferability of the studies could not be established due to a limitation present in the EURONHEED method. All existing economic evaluations in smoking cessation lack in one or more key study attributes necessary to be fully transferable to a new context. © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

  5. Model‐based economic evaluations in smoking cessation and their transferability to new contexts: a systematic review

    Science.gov (United States)

    Berg, Marrit L.; Cheung, Kei Long; Hiligsmann, Mickaël; Evers, Silvia; de Kinderen, Reina J. A.; Kulchaitanaroaj, Puttarin

    2017-01-01

    Abstract Aims To identify different types of models used in economic evaluations of smoking cessation, analyse the quality of the included models examining their attributes and ascertain their transferability to a new context. Methods A systematic review of the literature on the economic evaluation of smoking cessation interventions published between 1996 and April 2015, identified via Medline, EMBASE, National Health Service (NHS) Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA). The checklist‐based quality of the included studies and transferability scores was based on the European Network of Health Economic Evaluation Databases (EURONHEED) criteria. Studies that were not in smoking cessation, not original research, not a model‐based economic evaluation, that did not consider adult population and not from a high‐income country were excluded. Findings Among the 64 economic evaluations included in the review, the state‐transition Markov model was the most frequently used method (n = 30/64), with quality adjusted life years (QALY) being the most frequently used outcome measure in a life‐time horizon. A small number of the included studies (13 of 64) were eligible for EURONHEED transferability checklist. The overall transferability scores ranged from 0.50 to 0.97, with an average score of 0.75. The average score per section was 0.69 (range = 0.35–0.92). The relative transferability of the studies could not be established due to a limitation present in the EURONHEED method. Conclusion All existing economic evaluations in smoking cessation lack in one or more key study attributes necessary to be fully transferable to a new context. PMID:28060453

  6. Which Lynch syndrome screening programs could be implemented in the "real world"? A systematic review of economic evaluations.

    Science.gov (United States)

    Di Marco, Marco; D'Andrea, Elvira; Panic, Nikola; Baccolini, Valentina; Migliara, Giuseppe; Marzuillo, Carolina; De Vito, Corrado; Pastorino, Roberta; Boccia, Stefania; Villari, Paolo

    2018-01-04

    PurposeLynch syndrome (LS) screening can significantly reduce cancer morbidity and mortality in mutation carriers. Our aim was to identify cost-effective LS screening programs that can be implemented in the "real world."MethodsWe performed a systematic review of full economic evaluations of genetic screening for LS in different target populations; health outcomes were estimated in life-years gained or quality-adjusted life-years.ResultsOverall, 20 studies were included in the systematic review. Based on the study populations, we identified six categories of LS screening program: colorectal cancer (CRC)-based, endometrial cancer-based, general population-based, LS family registry-based, cascade testing-based, and genetics clinic-based screening programs. We performed an in-depth analysis of CRC-based LS programs, classifying them into three additional subcategories: universal, age-targeted, and selective. In five studies, universal programs based on immunohistochemistry, either alone or in combination with the BRAF test, were cost-effective compared with no screening, while in two studies age-targeted programs with a cutoff of 70 years were cost-effective when compared with age-targeted programs with lower age thresholds.ConclusionUniversal or <70 years-age-targeted CRC-based LS screening programs are cost-effective and should be implemented in the "real world."GENETICS in MEDICINE advance online publication, 4 January 2018; doi:10.1038/gim.2017.244.

  7. Long-term evaluation of periodontal parameters and implant outcomes in periodontally compromised patients: a systematic review.

    Science.gov (United States)

    Zangrando, Mariana Schutzer; Damante, Carla Andreotti; Sant'Ana, Adriana Campos; Rubo de Rezende, Maria Lúcia; Greghi, Sebastião Luiz; Chambrone, Leandro

    2015-02-01

    The aim of this systematic review is to evaluate the long-term outcomes of patients with periodontitis submitted to periodontal therapy/maintenance and implant placement. Studies reporting clinical and/or long-term implant outcomes from partially edentulous patients with periodontitis who were treated and followed periodontal maintenance for ≥5 years were considered eligible for the review. Screening of the articles, data extraction, and quality assessment were conducted independently and in duplicate. Search of MEDLINE, EMBASE, and CENTRAL databases resulted in 959 papers, and of them 931 were excluded after title/abstract assessment. The full texts of 28 potentially eligible publications were screened, but only 10 studies met inclusion criteria. Most of the included studies (77.8%) presented a medium/high methodologic quality. The results demonstrated that patients with a diagnosis of periodontitis had satisfactory implant outcomes. Implant survival was high (92.1%) within studies reporting 10 years of follow-up. Parameters related to probing depth, clinical attachment level, and bone loss around teeth increased the occurrence of peri-implantitis and implant loss. Non-attendance to periodontal maintenance and smoking habits were also associated with less favorable implant outcomes. This systematic review confirmed that implant therapy can be successfully used in patients with a diagnosis of periodontitis who underwent proper therapy and regular periodontal maintenance. Residual pockets, non-attendance to the periodontal maintenance program, and smoking were considered to be negative factors for the long-term implant outcomes.

  8. A Systematic Review on methods of evaluate sentence production deficits in agrammatic aphasia patients: Validity and Reliability issues

    Directory of Open Access Journals (Sweden)

    Azar Mehri

    2014-01-01

    Full Text Available Background: The grammar assessment in aphasia has been done by few standard tests, but today these tests cannot precise evaluate the sentence production in agrammatic patients. In this study, we review structures and contents of tests or tasks designed to find more frequent methods for sentence production ability in aphasia patients. Materials and Methods: We searched the Cochrane library, Medline by PubMed, Science Direct, Scopus, and Google Scholar from 1980 to October 1, 2013 and evaluated all of exist tests or tasks included in the articles and systematic reviews. The sentence production has been studied in three methods. It contains the use of sentence production in spontaneous speech, tasks designed and both methods. The quality of studies was assessed using Critical Appraisal Skills Program. Results: The 160 articles were reviewed and 38 articles were studied according to inclusion and exclusion criteria. They were classified into three categories based on assessment methods of sentence production. In 39.5% studies, researchers have used tasks designed, 7.9% articles have applied spontaneous speech and 52.6% articles have used both methods for evaluation production. Inter-rater reliability was between 90% and 100% and intra-rater reliability was between 96% and 98% in studied. Conclusion: Agrammatic aphasia has syntax disorders, especially in sentence production. Most researchers and clinicians used both methods for evaluation production.

  9. Systematic content evaluation and review of measurement properties of questionnaires for measuring self-reported fatigue among older people.

    Science.gov (United States)

    Egerton, Thorlene; Riphagen, Ingrid I; Nygård, Arnhild J; Thingstad, Pernille; Helbostad, Jorunn L

    2015-09-01

    The assessment of fatigue in older people requires simple and user-friendly questionnaires that capture the phenomenon, yet are free from items indistinguishable from other disorders and experiences. This study aimed to evaluate the content, and systematically review and rate the measurement properties of self-report questionnaires for measuring fatigue, in order to identify the most suitable questionnaires for older people. This study firstly involved identification of questionnaires that purport to measure self-reported fatigue, and evaluation of the content using a rating scale developed for the purpose from contemporary understanding of the construct. Secondly, for the questionnaires that had acceptable content, we identified studies reporting measurement properties and rated the methodological quality of those studies according to the COSMIN system. Finally, we extracted and synthesised the results of the studies to give an overall rating for each questionnaire for each measurement property. The protocol was registered with PROSPERO (CRD42013005589). Of the 77 identified questionnaires, twelve were selected for review after content evaluation. Methodological quality varied, and there was a lack of information on measurement error and responsiveness. The PROMIS-Fatigue item bank and short forms perform the best. The FACIT-Fatigue scale, Parkinsons Fatigue Scale, Perform Questionnaire, and Uni-dimensional Fatigue Impact Scale also perform well and can be recommended. Minor modifications to improve performance are suggested. Further evaluation of unresolved measurement properties, particularly with samples including older people, is needed for all the recommended questionnaires.

  10. Critical evaluation of paliperidone in the treatment of schizophrenia in Chinese patients: a systematic literature review

    Directory of Open Access Journals (Sweden)

    Zhang LL

    2016-01-01

    Full Text Available LiLi Zhang,1 JiTao Li,2–4 YanJie Zhao,5 Yun’Ai Su,2–4 Tianmei Si2–4 1Medical Affairs, Xian Janssen Pharmaceutical Co, Ltd, 2National Clinical Research Center for Mental Disorders, 3Peking University Sixth Hospital, Institute of Mental Health, 4The Key Laboratory of Mental Health, Ministry of Health, Peking University, 5National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China Background: Paliperidone (9-hydroxyrisperidone, the major active metabolite of risperidone, has been introduced as a novel atypical antipsychotic agent in many countries. It is available both as an oral extended-release (ER formulation and as a long-acting injection (paliperidone palmitate, PP, which have been approved for treating schizophrenia in the People’s Republic of China since 2009 and 2012, respectively. This systematic review summarizes the efficacy, effectiveness, and safety of paliperidone in the treatment of schizophrenia in the Chinese population. Methods: A systematic literature search was conducted on the databases covering international and Chinese core journals, published from January 1, 2008, to May 22, 2015. Results: A total of 122 publications were retrieved, of which 63 studies were identified for inclusion; most studies were related to paliperidone ER (n=53, nine were related to PP, and one study was related to both agents. Paliperidone ER demonstrated at least comparable efficacy with active comparators, including risperidone, olanzapine, ziprasidone, or aripiprazole, and was found to be superior with respect to the onset of action and improvement in the Personal and Social Performance Scale score. Paliperidone ER appeared to be associated with a lower risk of metabolic syndromes; the most common treatment-emergent adverse events were extrapyramidal symptoms, akathisia, insomnia, and somnolence. Results from interventional and observational studies showed that PP

  11. Reinforcer magnitude and rate dependency: evaluation of resistance-to-change mechanisms.

    Science.gov (United States)

    Pinkston, Jonathan W; Ginsburg, Brett C; Lamb, Richard J

    2014-10-01

    Under many circumstances, reinforcer magnitude appears to modulate the rate-dependent effects of drugs such that when schedules arrange for relatively larger reinforcer magnitudes rate dependency is attenuated compared with behavior maintained by smaller magnitudes. The current literature on resistance to change suggests that increased reinforcer density strengthens operant behavior, and such strengthening effects appear to extend to the temporal control of behavior. As rate dependency may be understood as a loss of temporal control, the effects of reinforcer magnitude on rate dependency may be due to increased resistance to disruption of temporally controlled behavior. In the present experiments, pigeons earned different magnitudes of grain during signaled components of a multiple FI schedule. Three drugs, clonidine, haloperidol, and morphine, were examined. All three decreased overall rates of key pecking; however, only the effects of clonidine were attenuated as reinforcer magnitude increased. An analysis of within-interval performance found rate-dependent effects for clonidine and morphine; however, these effects were not modulated by reinforcer magnitude. In addition, we included prefeeding and extinction conditions, standard tests used to measure resistance to change. In general, rate-decreasing effects of prefeeding and extinction were attenuated by increasing reinforcer magnitudes. Rate-dependent analyses of prefeeding showed rate-dependency following those tests, but in no case were these effects modulated by reinforcer magnitude. The results suggest that a resistance-to-change interpretation of the effects of reinforcer magnitude on rate dependency is not viable.

  12. Economic evaluations of occupational health interventions from a corporate perspective - A systematic review of methodological quality

    NARCIS (Netherlands)

    Uegaki, K.; Bruijne, M.C. de; Lambeek, L.; Anema, J.R.; Beek, A.J. van der; Mechelen, W. van; Tulder, M.W. van

    2010-01-01

    Objective: Using a standardized quality criteria list, we appraised the methodological quality of economic evaluations of occupational safety and health (OSH) interventions conducted from a corporate perspective. Methods: The primary literature search was conducted in Medline and Embase.

  13. A systematic review of evaluated suicide prevention programs targeting indigenous youth.

    Science.gov (United States)

    Harlow, Alyssa F; Bohanna, India; Clough, Alan

    2014-01-01

    Indigenous young people have significantly higher suicide rates than their non-indigenous counterparts. There is a need for culturally appropriate and effective suicide prevention programs for this demographic. This review assesses suicide prevention programs that have been evaluated for indigenous youth in Australia, Canada, New Zealand, and the United States. The databases MEDLINE and PsycINFO were searched for publications on suicide prevention programs targeting indigenous youth that include reports on evaluations and outcomes. Program content, indigenous involvement, evaluation design, program implementation, and outcomes were assessed for each article. The search yielded 229 articles; 90 abstracts were assessed, and 11 articles describing nine programs were reviewed. Two Australian programs and seven American programs were included. Programs were culturally tailored, flexible, and incorporated multiple-levels of prevention. No randomized controlled trials were found, and many programs employed ad hoc evaluations, poor program description, and no process evaluation. Despite culturally appropriate content, the results of the review indicate that more controlled study designs using planned evaluations and valid outcome measures are needed in research on indigenous youth suicide prevention. Such changes may positively influence the future of research on indigenous youth suicide prevention as the outcomes and efficacy will be more reliable.

  14. A six-step protocol to systematic process evaluation of multicomponent cluster-randomised health promoting interventions illustrated by the Boost study.

    Science.gov (United States)

    Aarestrup, Anne Kristine; Jørgensen, Thea Suldrup; Due, Pernille; Krølner, Rikke

    2014-10-01

    In multicomponent interventions it is important to examine the implementation of each component to enable valid assessments of the effectiveness of each component. Many studies do not systematically document, evaluate and report the level of implementation and there is a lack of systematic approaches to conduct process evaluation studies to guide researchers and evaluators. The aim of this study was to present a systematic approach to plan process evaluation of the implementation of randomised multicomponent interventions. Building on existing process evaluation frameworks and concepts, we developed a six-step protocol: 1. Brainstorm of processes necessary for full implementation and potential barriers and facilitators to implementation; 2. Application of process evaluation concepts to ensure inclusion of important implementation processes; 3. Measurement of proximal outcomes; 4. Identification of relevant data sources; 5. Selection of methods and timing of data collection of process measures; 6. Development of instruments. The protocol was applied to the Boost study, a multicomponent school-based dietary intervention. The protocol was readily applicable for planning process evaluation of environmental and educational intervention components in a school setting. The protocol ensures systematic assessment of the implementation processes that are crucial for interpretation of intervention effects. Current Controlled Trials ISRCTN11666034. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Treatment of Internet gaming disorder: An international systematic review and CONSORT evaluation.

    Science.gov (United States)

    King, Daniel L; Delfabbro, Paul H; Wu, Anise M S; Doh, Young Yim; Kuss, Daria J; Pallesen, Ståle; Mentzoni, Rune; Carragher, Natacha; Sakuma, Hiroshi

    2017-06-01

    Treatment services for Internet gaming disorder are becoming increasingly prevalent worldwide, particularly in East Asia. This international systematic review was designed to appraise the quality standards of the gaming disorder treatment literature, a task previously undertaken by King et al. (2011) prior to the inclusion of Internet gaming disorder in Section III of the DSM-5 and 'Gaming disorder' in the draft ICD-11. The reporting quality of 30 treatment studies conducted from 2007 to 2016 was assessed. Reporting quality was defined according to the 2010 Consolidating Standards of Reporting Trials (CONSORT) statement. The results reaffirmed previous criticisms of these trials, namely: (a) inconsistencies in the definition, diagnosis, and measurement of disordered use; (b) lack of randomization and blinding; (c) lack of controls; and (d) insufficient information on recruitment dates, sample characteristics, and effect sizes. Although cognitive-behavioral therapy has a larger evidence base than other therapies, it remains difficult to make definitive statements on its benefits. Study design quality has not improved over the last decade, indicating a need for greater consistency and standardization in this area. Continuing international efforts to understand the core psychopathology of gaming disorder are vital to developing a model of best practice in treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Comparison Groups in Yoga Research: A Systematic Review and Critical Evaluation of the Literature

    Science.gov (United States)

    Groessl, Erik; Maiya, Meghan; Sarkin, Andrew; Eisen, Susan V.; Riley, Kristen; Elwy, A. Rani

    2014-01-01

    Objectives Comparison groups are essential for accurate testing and interpretation of yoga intervention trials. However, selecting proper comparison groups is difficult because yoga comprises a very heterogeneous set of practices and its mechanisms of effect have not been conclusively established. Methods We conducted a systematic review of the control and comparison groups used in published randomized controlled trials (RCTs) of yoga. Results We located 128 RCTs that met our inclusion criteria; of these, 65 included only a passive control and 63 included at least one active comparison group. Primary comparison groups were physical exercise (43%), relaxation/meditation (20%), and education (16%). Studies rarely provided a strong rationale for choice of comparison. Considering year of publication, the use of active controls in yoga research appears to be slowly increasing over time. Conclusions Given that yoga has been established as a potentially powerful intervention, future research should use active control groups. Further, care is needed to select comparison conditions that help to isolate the specific mechanisms of yoga’s effects. PMID:25440384

  17. Evaluating the impact of immigration policies on health status among undocumented immigrants: a systematic review.

    Science.gov (United States)

    Martinez, Omar; Wu, Elwin; Sandfort, Theo; Dodge, Brian; Carballo-Dieguez, Alex; Pinto, Rogeiro; Rhodes, Scott D; Rhodes, Scott; Moya, Eva; Chavez-Baray, Silvia

    2015-06-01

    Over the past two decades, new anti-immigration policies and laws have emerged to address the migration of undocumented immigrants. A systematic review of the literature was conducted to assess and understand how these immigration policies and laws may affect both access to health services and health outcomes among undocumented immigrants. Eight databases were used to conduct this review, which returned 325 papers that were assessed for validity based on specified inclusion criteria. Forty critically appraised articles were selected for analysis; thirty articles related to access to health services, and ten related to health outcomes. The articles showed a direct relationship between anti-immigration policies and their effects on access to health services. In addition, as a result of these policies, undocumented immigrants were impacted by mental health outcomes, including depression, anxiety, and post-traumatic stress disorder. Action items were presented, including the promotion of cultural diversity training and the development of innovative strategies to support safety-net health care facilities serving vulnerable populations.

  18. Comparative evaluation of digital mammography and film mammography: systematic review and meta-analysis.

    Science.gov (United States)

    Iared, Wagner; Shigueoka, David Carlos; Torloni, Maria Regina; Velloni, Fernanda Garozzo; Ajzen, Sérgio Aron; Atallah, Alvaro Nagib; Valente, Orsine

    2011-01-01

    Mammography is the best method for breast-cancer screening and is capable of reducing mortality rates. Studies that have assessed the clinical impact of mammography have been carried out using film mammography. Digital mammography has been proposed as a substitute for film mammography given the benefits inherent to digital technology. The aim of this study was to compare the performance of digital and film mammography. Systematic review and meta-analysis. The Medline, Scopus, Embase and Lilacs databases were searched looking for paired studies, cohorts and randomized controlled trials published up to 2009 that compared the performance of digital and film mammography, with regard to cancer detection, recall rates and tumor characteristics. The reference lists of included studies were checked for any relevant citations. A total of 11 studies involving 190,322 digital and 638,348 film mammography images were included. The cancer detection rates were significantly higher for digital mammography than for film mammography (risk relative, RR = 1.17; 95% confidence interval, CI = 1.06-1.29; I² = 19%). The advantage of digital mammography seemed greatest among patients between 50 and 60 years of age. There were no significant differences between the two methods regarding patient recall rates or the characteristics of the tumors detected. The cancer detection rates using digital mammography are slightly higher than the rates using film mammography. There are no significant differences in recall rates between film and digital mammography. The characteristics of the tumors are similar in patients undergoing the two methods.

  19. Comparison groups in yoga research: a systematic review and critical evaluation of the literature.

    Science.gov (United States)

    Park, Crystal L; Groessl, Erik; Maiya, Meghan; Sarkin, Andrew; Eisen, Susan V; Riley, Kristen; Elwy, A Rani

    2014-10-01

    Comparison groups are essential for accurate testing and interpretation of yoga intervention trials. However, selecting proper comparison groups is difficult because yoga comprises a very heterogeneous set of practices and its mechanisms of effect have not been conclusively established. We conducted a systematic review of the control and comparison groups used in published randomized controlled trials (RCTs) of yoga. We located 128 RCTs that met our inclusion criteria; of these, 65 included only a passive control and 63 included at least one active comparison group. Primary comparison groups were physical exercise (43%), relaxation/meditation (20%), and education (16%). Studies rarely provided a strong rationale for choice of comparison. Considering year of publication, the use of active controls in yoga research appears to be slowly increasing over time. Given that yoga has been established as a potentially powerful intervention, future research should use active control groups. Further, care is needed to select comparison conditions that help to isolate the specific mechanisms of yoga's effects. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Systematic Classification of Disease Severity for Evaluation of Expanded Carrier Screening Panels.

    Directory of Open Access Journals (Sweden)

    Gabriel A Lazarin

    Full Text Available Professional guidelines dictate that disease severity is a key criterion for carrier screening. Expanded carrier screening, which tests for hundreds to thousands of mutations simultaneously, requires an objective, systematic means of describing a given disease's severity to build screening panels. We hypothesized that diseases with characteristics deemed to be of highest impact would likewise be rated as most severe, and diseases with characteristics of lower impact would be rated as less severe. We describe a pilot test of this hypothesis in which we surveyed 192 health care professionals to determine the impact of specific disease phenotypic characteristics on perceived severity, and asked the same group to rate the severity of selected inherited diseases. The results support the hypothesis: we identified four "Tiers" of disease characteristics (1-4. Based on these responses, we developed an algorithm that, based on the combination of characteristics normally seen in an affected individual, classifies the disease as Profound, Severe, Moderate, or Mild. This algorithm allows simple classification of disease severity that is replicable and not labor intensive.

  1. A Systematic Evaluation of Blood Serum and Plasma Pre-Analytics for Metabolomics Cohort Studies.

    Science.gov (United States)

    Jobard, Elodie; Trédan, Olivier; Postoly, Déborah; André, Fabrice; Martin, Anne-Laure; Elena-Herrmann, Bénédicte; Boyault, Sandrine

    2016-12-05

    The recent thriving development of biobanks and associated high-throughput phenotyping studies requires the elaboration of large-scale approaches for monitoring biological sample quality and compliance with standard protocols. We present a metabolomic investigation of human blood samples that delineates pitfalls and guidelines for the collection, storage and handling procedures for serum and plasma. A series of eight pre-processing technical parameters is systematically investigated along variable ranges commonly encountered across clinical studies. While metabolic fingerprints, as assessed by nuclear magnetic resonance, are not significantly affected by altered centrifugation parameters or delays between sample pre-processing (blood centrifugation) and storage, our metabolomic investigation highlights that both the delay and storage temperature between blood draw and centrifugation are the primary parameters impacting serum and plasma metabolic profiles. Storing the blood drawn at 4 °C is shown to be a reliable routine to confine variability associated with idle time prior to sample pre-processing. Based on their fine sensitivity to pre-analytical parameters and protocol variations, metabolic fingerprints could be exploited as valuable ways to determine compliance with standard procedures and quality assessment of blood samples within large multi-omic clinical and translational cohort studies.

  2. A Systematic Evaluation of Blood Serum and Plasma Pre-Analytics for Metabolomics Cohort Studies

    Directory of Open Access Journals (Sweden)

    Elodie Jobard

    2016-12-01

    Full Text Available The recent thriving development of biobanks and associated high-throughput phenotyping studies requires the elaboration of large-scale approaches for monitoring biological sample quality and compliance with standard protocols. We present a metabolomic investigation of human blood samples that delineates pitfalls and guidelines for the collection, storage and handling procedures for serum and plasma. A series of eight pre-processing technical parameters is systematically investigated along variable ranges commonly encountered across clinical studies. While metabolic fingerprints, as assessed by nuclear magnetic resonance, are not significantly affected by altered centrifugation parameters or delays between sample pre-processing (blood centrifugation and storage, our metabolomic investigation highlights that both the delay and storage temperature between blood draw and centrifugation are the primary parameters impacting serum and plasma metabolic profiles. Storing the blood drawn at 4 °C is shown to be a reliable routine to confine variability associated with idle time prior to sample pre-processing. Based on their fine sensitivity to pre-analytical parameters and protocol variations, metabolic fingerprints could be exploited as valuable ways to determine compliance with standard procedures and quality assessment of blood samples within large multi-omic clinical and translational cohort studies.

  3. Evaluating effectiveness in adolescent mental health inpatient units: A systematic review.

    Science.gov (United States)

    Hayes, Claire; Simmons, Magenta; Simons, Christine; Hopwood, Malcolm

    2017-12-01

    Adolescent mental health research is a developing area. Inpatient units are the most widely used acute element of adolescent mental health services internationally. Little is known about inpatient units, particularly when it comes to measuring improvement for adolescents. Clinical outcome measurement in the broad context has gathered momentum in recent years, driven by the need to assess services. The measurement of outcomes for adolescents who access inpatient care is critical, as they are particularly vulnerable and are often considered the most difficult to treat. Following the PRISMA guidelines, the aim of this review was to assess whether adolescent inpatient units are effective and understand how outcomes are measured. CINAHL, MEDLINE with Full Text, ERIC, PsycINFO, and Cochrane databases were systematically searched. Studies were included if the inpatient units were generic and adolescents were between the mean age of 12-25 years. Furthermore, studies published in English within the last ten years were included. Exclusions were outpatient and disorder-specific inpatient settings. A total of 16 studies were identified. Each study demonstrated effectiveness on at least one outcome measure in terms of symptom stabilization. However, several outcome measures were used and therefore inpatient units lack consistency in how they measure improvement. Inpatient units are effective for the majority of young people as they result in symptom stabilization. Whilst symptom stabilization can be achieved, future research examining the mechanism of change is needed. © 2017 Australian College of Mental Health Nurses Inc.

  4. Efficacy, Tolerability, and Dose-Dependent Effects of Opioid Analgesics for Low Back Pain: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Abdel Shaheed, Christina; Maher, Chris G; Williams, Kylie A; Day, Richard; McLachlan, Andrew J

    2016-07-01

    Opioid analgesics are commonly used for low back pain, however, to our knowledge there has been no systematic evaluation of the effect of opioid dose and use of enrichment study design on estimates of treatment effect. To evaluate efficacy and tolerability of opioids in the management of back pain; and investigate the effect of opioid dose and use of an enrichment study design on treatment effect. Medline, EMBASE, CENTRAL, CINAHL, and PsycINFO (inception to September 2015) with citation tracking from eligible randomized clinical trials (RCTs). Placebo-controlled RCTs in any language. Two authors independently extracted data and assessed risk of bias. Data were pooled using a random effects model with strength of evidence assessed using the grading of recommendations assessment, development, and evaluation (GRADE). The primary outcome measure was pain. Pain and disability outcomes were converted to a common 0 to 100 scale, with effects greater than 20 points considered clinically important. Of 20 included RCTs of opioid analgesics (with a total of 7925 participants), 13 trials (3419 participants) evaluated short-term effects on chronic low back pain, and no placebo-controlled trials enrolled patients with acute low back pain. In half of these 13 trials, at least 50% of participants withdrew owing to adverse events or lack of efficacy. There was moderate-quality evidence that opioid analgesics reduce pain in the short term; mean difference (MD), -10.1 (95% CI, -12.8 to -7.4). Meta-regression revealed a 12.0 point greater pain relief for every 1 log unit increase in morphine equivalent dose (P = .046). Clinically important pain relief was not observed within the dose range evaluated (40.0-240.0-mg morphine equivalents per day). There was no significant effect of enrichment study design. For people with chronic low back pain who tolerate the medicine, opioid analgesics provide modest short-term pain relief but the effect is not likely to be clinically important

  5. Systematic review

    DEFF Research Database (Denmark)

    Bager, Palle; Chauhan, Usha; Greveson, Kay

    2017-01-01

    OBJECTIVE: Advice lines for patients with inflammatory bowel diseases (IBD) have been introduced internationally. However, only a few publications have described the advice line service and evaluated the efficiency of it with many results presented as conference posters. A systematic synthesis of...

  6. Evaluation of linearity of response and angular dependence of an ionization chamber for dosimetry in computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Perini, Ana P.; Neves, Lucio P.; Xavier, Marcos; Caldas, Linda V.E., E-mail: mxavier@ipen.b, E-mail: lcaldas@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Khoury, Helen J., E-mail: khoury@ufpe.b [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Dept. de Energia Nuclear

    2011-07-01

    In this paper a pencil-type ionization chamber designed and manufactured at Instituto de Pesquisas Energeticas e Nucleares was evaluated for dosimetric applications in computed tomography beams. To evaluate the performance of this chamber two tests were undertaken: linearity of response and angular dependence. The results obtained in these tests showed good results, within the international recommendations. Moreover, this homemade ionization chamber is easy to manufacture, of low cost and efficient. (author)

  7. SustainPro - A tool for systematic process analysis, generation and evaluation of sustainable design alternatives

    DEFF Research Database (Denmark)

    Carvalho, Ana; Matos, Henrique A.; Gani, Rafiqul

    2013-01-01

    Chemical processes are continuously facing challenges from the demands of the global market related to economics, environment and social issues. This paper presents the development of a software tool (SustainPro) and its application to chemical processes operating in batch or continuous modes...... the user through the necessary steps according to work-flow of the implemented methodology. At the end the design alternatives, are evaluated using environmental impact assessment tools and safety indices. The extended features of the methodology incorporate Life Cycle Assessment analysis and economic....... The software tool is based on the implementation of an extended systematic methodology for sustainable process design (Carvalho et al. 2008 and Carvalho et al. 2009). Using process information/data such as the process flowsheet, the associated mass / energy balance data and the cost data, SustainPro guides...

  8. Difficulty Systematized Evaluation of Vocal Folds Exposure in Microsurgery of the Larynx

    Directory of Open Access Journals (Sweden)

    Ballin, Annelyse Cristine

    2010-09-01

    Full Text Available Introduction: Several studies addressing preoperative factors that predict difficulty of endotracheal intubation graduated by anesthesiologists, for the scale of the Cormack-Lehane. These parameters were evaluated for the difficulty of location of the laryngoscope in microsurgery of the larynx. There is not a standard scale of difficulty targeted to surgeons of the larynx. Objective: Create a standard scale of difficulty leasing the laryngoscope during microsurgery of the larynx, with a focus on exposure of the vocal folds (vocal cords to evaluate which clinical parameters predict difficulty of exposure of their vocal folds and verify the improvement of laryngeal exposure with the hanger of the laryngoscope. Method: A prospective randomized study, 57 patients undergoing laryngeal microsurgery. The preoperative parameters were evaluated: three epidemiological data, two of history and 13 physical examination. Intraoperatively: the anesthesiologist evaluated the Cormack-Lehane score and the surgeon evaluated according to the proposed scale, before and after placement of the hanger. Results and Conclusion: Several parameters showed sensitivity, specificity, positive predictive value for high inadequate exposure of the larynx. But only distance hiomentual <6.05 cm (p = 0.003 and 2 classes of Cormack-Lehane (p = 0.04 with statistical significance and high sensitivity of 100% and 81% respectively. The use of the hanger of laryngoscope laryngeal exposure improved significantly (p = 0.04. The proposed scale standardizes the visualization and grades the difficulty of exposure of their vocal folds, facilitating comparisons between studies and communication between otolaryngologists.

  9. Systematic Heuristic Evaluation of Computerized Consultation Order Templates: Clinicians' and Human Factors Engineers' Perspectives.

    Science.gov (United States)

    Savoy, April; Patel, Himalaya; Flanagan, Mindy E; Weiner, Michael; Russ, Alissa L

    2017-08-01

    We assessed the usability of consultation order templates and identified problems to prioritize in design efforts for improving referral communication. With a sample of 26 consultation order templates, three evaluators performed a usability heuristic evaluation. The evaluation used 14 domain-independent heuristics and the following three supplemental references: 1 new domain-specific heuristic, 6 usability goals, and coded clinicians' statements regarding ease of use for 10 sampled templates. Evaluators found 201 violations, a mean of 7.7 violations per template. Minor violations outnumbered major violations almost twofold, 115 (57%) to 62 (31%). Approximately 68% of violations were linked to 5 heuristics: aesthetic and minimalist design (17%), error prevention (16%), consistency and standards (14%), recognition rather than recall (11%), and meet referrers' information needs (10%). Severe violations were attributed mostly to meet referrers' information needs and recognition rather than recall. Recorded violations yielded potential negative consequences for efficiency, effectiveness, safety, learnability, and utility. Evaluators and clinicians demonstrated 80% agreement in usability assessment. Based on frequency and severity of usability heuristic violations, the consultation order templates reviewed may impede clinical efficiency and risk patient safety. Results support the following design considerations: communicate consultants' requirements, facilitate information seeking, and support communication. While the most frequent heuristic violations involved interaction design and presentation, the most severe violations lacked information desired by referring clinicians. Violations related to templates' inability to support referring clinicians' information needs had the greatest potential negative impact on efficiency and safety usability goals. Heuristics should be prioritized in future design efforts.

  10. Methodological Challenges to the Evaluation of Interventions for Foster/Kinship Carers and Children: A Systematic Review.

    Science.gov (United States)

    Dickes, Adam; Kemmis-Riggs, Jacqueline; McAloon, John

    2017-11-24

    Caregivers of children in alternative care face a complex range of challenges that can result in placement disruption and poor long-term outcomes. Interventions designed to help carers meet these challenges report positive outcomes. Nevertheless, several reviewers have reported these positive results may be mitigated by limitations in trial methodology. This review aims to systematically review these methodological challenges and limitations, to provide an analysis of the current state of the evidence base for these interventions. A systematic review was conducted into the methods used to evaluate the effectiveness of psychosocial interventions for foster and kinship carers. Limitations relating to internal validity, external validity and clinical heterogeneity were identified and synthesised. Seventeen studies met inclusion criteria. The quality of methods used in the included studies is mixed, with high and unknown levels of bias in the majority of trials. Heterogeneity in participant characteristics, intervention aims and outcome measures across interventions reflect the diversity of carer and child needs and make it difficult to generalise results or compare and synthesise the efficacy of different interventions. These factors limit the application of trial results to evidence-based clinical practice. The diverse and complex needs of this population present significant challenges to robustly evaluating interventions for foster/kinship families. Participant needs, theoretical approaches, intervention aims and outcome measures need to be better coordinated, both within trials and across the field. Exploratory research should be used to generate focussed and concrete hypotheses that can be robustly tested in high-quality randomised controlled trials. Protocol registration number: CRD 42017048415.

  11. Evaluation of Effect of Foraminal Enlargement of Necrotic Teeth on Postoperative Symptoms: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Borges Silva, Erlange Andrade; Guimarães, Ludmila Silva; Küchler, Erika Calvano; Antunes, Lívia Azeredo A; Antunes, Leonardo Santos

    2017-10-12

    The intentional enlargement of the apical foramen is designed to reduce the microbial load in the apical foramen, or even beyond, to levels more favorable for repair. This study provides a systematic review and meta-analysis to address the PICOS question: in adult patients who undergo endodontic treatment, does foraminal enlargement (FE) cause different postoperative symptoms in comparison with conventional endodontic treatment? The PROSPERO registration number is CRD42017059921 and was conducted following the PRISMA statements. A broad search was conducted in the electronic databases PubMed, Web of Science, Scopus, Cochrane Library, and grey literature for articles published through May 2017. The MeSH terms "Pain," "Hyperemia," "Edema," "Hyperesthesia," "Fistula," "Root canal preparation," "Tooth apex," "Periapical periodontitis," "Dental pulp necrosis," and "Clinical study" were used. The reviewers evaluated the studies for eligibility criteria and performed data abstraction and risk of bias evaluations. A random-effects model was used for the meta-analysis. Five studies qualified for systematic review, and 3 studies were considered for meta-analysis. The results of the meta-analysis showed that postoperative pain is higher in the endodontic treatment with FE, with a statistically significant difference in the first, second, fourth, sixth, and seventh days. Limited data indicated that no significant difference was found in analgesic consumption, flare-up, and swelling between the groups. Postoperative pain was higher in the FE group compared with conventional endodontic therapy in the first days after treatment in teeth with necrosis and apical periodontitis. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  12. Meniscus matrix morphological composition: age-dependent evaluation in a swine model

    Directory of Open Access Journals (Sweden)

    Umberto Polito

    2017-06-01

    Full Text Available Menisci are fibro-cartilaginous structures interposed between femoral condyle and tibial plateau, which have multiple functions in the stifle joint: act as shock absorbers, bear loaders and allow joint stability, congruity and lubrication (Sweigart et al., 2004; Proffen et al., 2012. It is well known that meniscal injuries lead to osteoarthritis and for these reasons, menisci are considered important target of investigation. Their important role in the knee wellness is only equalled by their deficiency in proper self-repairing. Nowadays, the gold standard technique is not just to remove the damaged meniscus, but to rebuild it or to replace it. For these reasons, studies are necessary to increase the knowledge about these small but essential structures (Streuli, 1999; Deponti et al., 2013. Composition and morphology are basic fundamental information for the development of engineered meniscal substitutes (Di Giancamillo et al., 2014. The analysis of the morphological, structural and biochemical changes, which occur during growth of the normal menisci, represent the goal of the present study. For this purpose, menisci from adult (7-month old, young (1-month old, and neonates (stillbirths pigs were collected. Cellularity and glycosamiglycans (GAGs deposition were evaluated by ELISA, while Collagen-1 and Collagen-2 were investigated by immunohistochemistry and Western blot analyses. Cellularity (P<0.01, all comparisons and Collagen-1 (P<0.05, neonatal-young vs adult decreased from neonatal to adult stage while GAGs (P<0.01 neonatal vs young-adult and Collagen-2 (P<0.01 neonatal-young vs adult showed the opposite trend. Immunohistochemistry revealed similar changes occurring during animal growth thus revealing that cellular phenotype, cellularity and protein expression, as well as fibers aggregation in the matrix, are dissimilar in the three ages analysed categories. These changes reflect the progressive menisci maturation and hyper-specialisation. We

  13. A systematic review of economic evaluations of treatments for patients with epilepsy.

    Science.gov (United States)

    Wijnen, Ben F M; van Mastrigt, Ghislaine A P G; Evers, Silvia M A A; Gershuni, Olga; Lambrechts, Danielle A J E; Majoie, Marian H J M; Postulart, Debby; Aldenkamp, Bert A P; de Kinderen, Reina J A

    2017-05-01

    The increasing number of treatment options and the high costs associated with epilepsy have fostered the development of economic evaluations in epilepsy. It is important to examine the availability and quality of these economic evaluations and to identify potential research gaps. As well as looking at both pharmacologic (antiepileptic drugs [AEDs]) and nonpharmacologic (e.g., epilepsy surgery, ketogenic diet, vagus nerve stimulation) therapies, this review examines the methodologic quality of the full economic evaluations included. Literature search was performed in MEDLINE, EMBASE, NHS Economic Evaluation Database (NHS EED), Econlit, Web of Science, and CEA Registry. In addition, Cochrane Reviews, Cochrane DARE and Cochrane Health Technology Assessment Databases were used. To identify relevant studies, predefined clinical search strategies were combined with a search filter designed to identify health economic studies. Specific search strategies were devised for the following topics: (1) AEDs, (2) patients with cognitive deficits, (3) elderly patients, (4) epilepsy surgery, (5) ketogenic diet, (6) vagus nerve stimulation, and (7) treatment of (non)convulsive status epilepticus. A total of 40 publications were included in this review, 29 (73%) of which were articles about pharmacologic interventions. Mean quality score of all articles on the Consensus Health Economic Criteria (CHEC)-extended was 81.8%, the lowest quality score being 21.05%, whereas five studies had a score of 100%. Looking at the Consolidated Health Economic Evaluation Reporting Standards (CHEERS), the average quality score was 77.0%, the lowest being 22.7%, and four studies rated as 100%. There was a substantial difference in methodology in all included articles, which hampered the attempt to combine information meaningfully. Overall, the methodologic quality was acceptable; however, some studies performed significantly worse than others. The heterogeneity between the studies stresses the need to

  14. Systematic evaluation of CS-Rosetta for membrane protein structure prediction with sparse NOE restraints.

    Science.gov (United States)

    Reichel, Katrin; Fisette, Olivier; Braun, Tatjana; Lange, Oliver F; Hummer, Gerhard; Schäfer, Lars V

    2017-05-01

    We critically test and validate the CS-Rosetta methodology for de novo structure prediction of α-helical membrane proteins (MPs) from NMR data, such as chemical shifts and NOE distance restraints. By systematically reducing the number and types of NOE restraints, we focus on determining the regime in which MP structures can be reliably predicted and pinpoint the boundaries of the approach. Five MPs of known structure were used as test systems, phototaxis sensory rhodopsin II (pSRII), a subdomain of pSRII, disulfide binding protein B (DsbB), microsomal prostaglandin E2 synthase-1 (mPGES-1), and translocator protein (TSPO). For pSRII and DsbB, where NMR and X-ray structures are available, resolution-adapted structural recombination (RASREC) CS-Rosetta yields structures that are as close to the X-ray structure as the published NMR structures if all available NMR data are used to guide structure prediction. For mPGES-1 and Bacillus cereus TSPO, where only X-ray crystal structures are available, highly accurate structures are obtained using simulated NMR data. One main advantage of RASREC CS-Rosetta is its robustness with respect to even a drastic reduction of the number of NOEs. Close-to-native structures were obtained with one randomly picked long-range NOEs for every 14, 31, 38, and 8 residues for full-length pSRII, the pSRII subdomain, TSPO, and DsbB, respectively, in addition to using chemical shifts. For mPGES-1, atomically accurate structures could be predicted even from chemical shifts alone. Our results show that atomic level accuracy for helical membrane proteins is achievable with CS-Rosetta using very sparse NOE restraint sets to guide structure prediction. Proteins 2017; 85:812-826. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  15. Instruments to evaluate mobility capacity of older adults during hospitalization: A systematic review.

    Science.gov (United States)

    Soares Menezes, Karla Vanessa Rodrigues; Auger, Claudine; de Souza Menezes, Weslley Rodrigues; Guerra, Ricardo Oliveira

    2017-09-01

    Independent mobility is a key factor in predicting morbidity and determining hospital discharge readiness for older patients. The main objective was identify and appraise relevant instruments for the measurement of mobility of hospitalized geriatric patients. A systematic review was performed in two consecutive steps. Based on the definition of mobility of the International Classification of Functioning (ICF). Step 1 identified mobility measurement instruments used to assess patients 60 years of age and over hospitalized in acute care or intensive geriatric rehabilitation unit. Aim of the instrument, coverage of mobility construct, applicability (format, training required, administration time and use of assistive devices) were extracted. For each included instrument, Step 2 identified and appraised articles reporting about their measurement properties. Consensus-based Standards for the selection of health status Measurement INstruments (COSMIN) was used by two independent reviewers to critically appraise and compare the measurement properties. Step 1 resulted in 6350 articles, of which 28 articles reported about 17 different instruments. Step 2 retained 11 instruments with 70 articles reporting about their measurement properties in various settings. Judgement-based instruments (n=5) covered the ICF mobility construct more broadly than performance-based measures (n=6). Our results showed that 3 instruments (DEMMI, SPPB and Tinetti scale) had the most extensive and robust measurement properties, and from those, SPPB and DEMMI covered the mobility construct more broadly but SPPB had the longest administration (10-15min). Conclusion SPPB presents the best balance between mobility coverage, measurement properties and applicability to acute care or intensive geriatric rehabilitation unit. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Systematic evaluation of the metabolic to mitogenic potency ratio for B10-substituted insulin analogues.

    Directory of Open Access Journals (Sweden)

    Tine Glendorf

    Full Text Available BACKGROUND: Insulin analogues comprising acidic amino acid substitutions at position B10 have previously been shown to display increased mitogenic potencies compared to human insulin and the underlying molecular mechanisms have been subject to much scrutiny and debate. However, B10 is still an attractive position for amino acid substitutions given its important role in hexamer formation. The aim of this study was to investigate the relationships between the receptor binding properties as well as the metabolic and mitogenic potencies of a series of insulin analogues with different amino acid substitutions at position B10 and to identify a B10-substituted insulin analogue without an increased mitogenic to metabolic potency ratio. METHODOLOGY/PRINCIPAL FINDINGS: A panel of ten singly-substituted B10 insulin analogues with different amino acid side chain characteristics were prepared and insulin receptor (both isoforms and IGF-I receptor binding affinities using purified receptors, insulin receptor dissociation rates using BHK cells over-expressing the human insulin receptor, metabolic potencies by lipogenesis in isolated rat adipocytes, and mitogenic potencies using two different cell types predominantly expressing either the insulin or the IGF-I receptor were systematically investigated. Only analogues B10D and B10E with significantly increased insulin and IGF-I receptor affinities as well as decreased insulin receptor dissociation rates displayed enhanced mitogenic potencies in both cell types employed. For the remaining analogues with less pronounced changes in receptor affinities and insulin receptor dissociation rates, no apparent correlation between insulin receptor occupancy time and mitogenicity was observed. CONCLUSIONS/SIGNIFICANCE: Several B10-substituted insulin analogues devoid of disproportionate increases in mitogenic compared to metabolic potencies were identified. In the present study, receptor binding affinity rather than insulin

  17. Comparative evaluation of digital mammography and film mammography: systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Wagner Iared

    Full Text Available CONTEXT AND OBJECTIVE: Mammography is the best method for breast-cancer screening and is capable of reducing mortality rates. Studies that have assessed the clinical impact of mammography have been carried out using film mammography. Digital mammography has been proposed as a substitute for film mammography given the benefits inherent to digital technology. The aim of this study was to compare the performance of digital and film mammography. DESIGN: Systematic review and meta-analysis. METHOD: The Medline, Scopus, Embase and Lilacs databases were searched looking for paired studies, cohorts and randomized controlled trials published up to 2009 that compared the performance of digital and film mammography, with regard to cancer detection, recall rates and tumor characteristics. The reference lists of included studies were checked for any relevant citations. RESULTS: A total of 11 studies involving 190,322 digital and 638,348 film mammography images were included. The cancer detection rates were significantly higher for digital mammography than for film mammography (risk relative, RR = 1.17; 95% confidence interval, CI = 1.06-1.29; I² = 19%. The advantage of digital mammography seemed greatest among patients between 50 and 60 years of age. There were no significant differences between the two methods regarding patient recall rates or the characteristics of the tumors detected. CONCLUSION: The cancer detection rates using digital mammography are slightly higher than the rates using film mammography. There are no significant differences in recall rates between film and digital mammography. The characteristics of the tumors are similar in patients undergoing the two methods.

  18. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration

    DEFF Research Database (Denmark)

    Liberati, Alessandro; Altman, Douglas G; Tetzlaff, Jennifer

    2009-01-01

    and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realizing these issues, an international group that included experienced authors and methodologists developed PRISMA (Preferred Reporting Items for Systematic...... reviews and Meta-Analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions. The PRISMA Statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential....... The PRISMA Statement, this document, and the associated Web site (http://www.prisma-statement.org/) should be helpful resources to improve reporting of systematic reviews and meta-analyses....

  19. Instruments for the evaluation of motor abilities for children with severe multiple disabilities: A systematic review of the literature.

    Science.gov (United States)

    Mensch, Sonja M; Rameckers, Eugène A A; Echteld, Michael A; Evenhuis, Heleen M

    2015-12-01

    Based on a systematic review, psychometric characteristics of currently available instruments on motor abilities of children with disabilities were evaluated, with the aim to identify candidates for use in children with severe multiple (intellectual and motor) disabilities. In addition, motor abilities are essential for independent functioning, but are severely compromised in these children. The methodological quality of all studies was evaluated with the Consensus Based Standards for the Selection of Health Status Measurement Instruments (COSMIN) Checklist; overall levels of evidence per instrument were based on the Cochrane Back Review Group strategy. As a result, 18 studies with a total of eight instruments, developed for children with cerebral palsy (CLA, GMFM-88 and LE85), spinal muscular atrophy (MHFMS), neuromuscular diseases (MFM), disabilities 0-6 years (VAB, WeeFIM), and one developed specifically for children with severe multiple disabilities (TDMMT) were found. Strong levels of evidence were found for construct validity of LE85 and MFM and for responsiveness of WeeFIM, but reliability studies of these instruments had a limited methodological quality. Up to now studies of the TDMMT resulted in limited and unknown evidence for structural validity due to the poor methodological quality of reliability studies. In a next step, the clinical suitability of the instruments for children with severe multiple disabilities will be evaluate. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Technical Note: Evaluation of the systematic accuracy of a frameless, multiple image modality guided, linear accelerator based stereotactic radiosurgery system

    Energy Technology Data Exchange (ETDEWEB)

    Wen, N., E-mail: nwen1@hfhs.org; Snyder, K. C.; Qin, Y.; Li, H.; Siddiqui, M. S.; Chetty, I. J. [Department of Radiation Oncology, Henry Ford Health System, 2799 West Brand Boulevard, Detroit, Michigan 48202 (United States); Scheib, S. G.; Schmelzer, P. [Varian Medical System, Täfernstrasse 7, Dättwil AG 5405 (Switzerland)

    2016-05-15

    Purpose: To evaluate the total systematic accuracy of a frameless, image guided stereotactic radiosurgery system. Methods: The localization accuracy and intermodality difference was determined by delivering radiation to an end-to-end prototype phantom, in which the targets were localized using optical surface monitoring system (OSMS), electromagnetic beacon-based tracking (Calypso®), cone-beam CT, “snap-shot” planar x-ray imaging, and a robotic couch. Six IMRT plans with jaw tracking and a flattening filter free beam were used to study the dosimetric accuracy for intracranial and spinal stereotactic radiosurgery treatment. Results: End-to-end localization accuracy of the system evaluated with the end-to-end phantom was 0.5 ± 0.2 mm with a maximum deviation of 0.9 mm over 90 measurements (including jaw, MLC, and cone measurements for both auto and manual fusion) for single isocenter, single target treatment, 0.6 ± 0.4 mm for multitarget treatment with shared isocenter. Residual setup errors were within 0.1 mm for OSMS, and 0.3 mm for Calypso. Dosimetric evaluation based on absolute film dosimetry showed greater than 90% pass rate for all cases using a gamma criteria of 3%/1 mm. Conclusions: The authors’ experience demonstrates that the localization accuracy of the frameless image-guided system is comparable to robotic or invasive frame based radiosurgery systems.

  1. Systematic review of ERP and fMRI studies investigating inhibitory control and error processing in people with substance dependence and behavioural addictions

    Science.gov (United States)

    Luijten, Maartje; Machielsen, Marise W.J.; Veltman, Dick J.; Hester, Robert; de Haan, Lieuwe; Franken, Ingmar H.A.

    2014-01-01

    Background Several current theories emphasize the role of cognitive control in addiction. The present review evaluates neural deficits in the domains of inhibitory control and error processing in individuals with substance dependence and in those showing excessive addiction-like behaviours. The combined evaluation of event-related potential (ERP) and functional magnetic resonance imaging (fMRI) findings in the present review offers unique information on neural deficits in addicted individuals. Methods We selected 19 ERP and 22 fMRI studies using stop-signal, go/no-go or Flanker paradigms based on a search of PubMed and Embase. Results The most consistent findings in addicted individuals relative to healthy controls were lower N2, error-related negativity and error positivity amplitudes as well as hypoactivation in the anterior cingulate cortex (ACC), inferior frontal gyrus and dorsolateral prefrontal cortex. These neural deficits, however, were not always associated with impaired task performance. With regard to behavioural addictions, some evidence has been found for similar neural deficits; however, studies are scarce and results are not yet conclusive. Differences among the major classes of substances of abuse were identified and involve stronger neural responses to errors in individuals with alcohol dependence versus weaker neural responses to errors in other substance-dependent populations. Limitations Task design and analysis techniques vary across studies, thereby reducing comparability among studies and the potential of clinical use of these measures. Conclusion Current addiction theories were supported by identifying consistent abnormalities in prefrontal brain function in individuals with addiction. An integrative model is proposed, suggesting that neural deficits in the dorsal ACC may constitute a hallmark neurocognitive deficit underlying addictive behaviours, such as loss of control. PMID:24359877

  2. Should psychosocial intervention be added to pharmacological treatment for opiate abuse/dependence? An overview of systematic reviews of the literature

    Directory of Open Access Journals (Sweden)

    Laura Amato

    2006-06-01

    Full Text Available

    Background: Opioid abuse and dependence are major health and social issues in most societies. Different interventions are available, but the majority of heroin patients relapse and these relapses are a substantial problem to their rehabilitation. Psychosocial interventions for drug addicts have been suggested as possible instruments to overcome the difficulty of maintaining a drug-free state. The aim of this paper is to provide a summary of the available evidence of effectiveness.

    Methods: We summarised the results from two systematic reviews on psychosocial interventions combined with Methadone Maintenance Treatment and Methadone or Buprenorphine Detoxification Treatment.

    Results: For detoxification treatments, the results show that benefits can be gained from adding any psychosocial treatment to any substitution detoxification treatment in terms of completion of treatment: relative risk (RR 1.68 (95% CI 1.11-2.55, and compliance (proportion of clinical absences: RR 0.48 (95% CI 0.38-0.59; for the use of heroin during treatment, the differences were not statistically significant. For maintenance treatments, there is an additional benefit to be gained in adding any psychosocial treatment to methadone maintenance treatment in relation to the use of heroin during treatment: RR 0.69(95% CI 0.53-0.91; no statistically significant additional benefit was shown in terms of treatment retention and results at follow-up.

    Conclusions: Psychosocial treatments offered in addition to pharmacological detoxification treatments are effective in terms of completion of treatment and compliance, while adding any psychosocial support to methadone maintenance significantly improves the non-use of heroin during treatment but does not improve the other outcomes considered.

  3. Communication and support from health-care professionals to families, with dependent children, following the diagnosis of parental life-limiting illness: A systematic review.

    Science.gov (United States)

    Fearnley, Rachel; Boland, Jason W

    2017-03-01

    Communication between parents and their children about parental life-limiting illness is stressful. Parents want support from health-care professionals; however, the extent of this support is not known. Awareness of family's needs would help ensure appropriate support. To find the current literature exploring (1) how parents with a life-limiting illness, who have dependent children, perceive health-care professionals' communication with them about the illness, diagnosis and treatments, including how social, practical and emotional support is offered to them and (2) how this contributes to the parents' feelings of supporting their children. A systematic literature review and narrative synthesis. Embase, MEDLINE, PsycINFO, CINAHL and ASSIA ProQuest were searched in November 2015 for studies assessing communication between health-care professionals and parents about how to talk with their children about the parent's illness. There were 1342 records identified, five qualitative studies met the inclusion criteria (55 ill parents, 11 spouses/carers, 26 children and 16 health-care professionals). Parents wanted information from health-care professionals about how to talk to their children about the illness; this was not routinely offered. Children also want to talk with a health-care professional about their parents' illness. Health-care professionals are concerned that conversations with parents and their children will be too difficult and time-consuming. Parents with a life-limiting illness want support from their health-care professionals about how to communicate with their children about the illness. Their children look to health-care professionals for information about their parent's illness. Health-care professionals, have an important role but appear reluctant to address these concerns because of fears of insufficient time and expertise.

  4. A Systematic Mapping Study on Empirical Evaluation of Software Requirements Specifications Techniques

    NARCIS (Netherlands)

    Condori-Fernandez, Nelly; Condori-Fernandez, Nelly; Daneva, Maia; Sikkel, Nicolaas; Wieringa, Roelf J.; Dieste, Oscar; Pastor, Oscar; Williams, L.; Miller, J.; Selby, R.

    2009-01-01

    This paper describes an empirical mapping study, which was designed to identify what aspects of Software Requirement Specifications (SRS) are empirically evaluated, in which context, and by using which research method. On the basis of 46 identified and categorized primary studies, we found that

  5. Evaluation of neuromotor function in infancy - A systematic review of available methods

    NARCIS (Netherlands)

    Heineman, Kirsten R.; Hadders-Algra, Mijna

    Objective: Neuromotor function in infancy can be evaluated in various ways. Assessment instruments are used for early detection of children with a high risk for developmental disorders. Early detection enables clinicians to provide intervention at a young age when plasticity of the nervous system is

  6. Tangible Line Graphs: An Evaluation and Some Systematic Strategies for Exploration.

    Science.gov (United States)

    Lederman, Susan J.; Campbell, Jamie I.

    1983-01-01

    Initial research is reported on development of a tangible graphics (a display with raised symbols for reading by hand rather than by eye) system and its evaluation by 20 blind adults. Results suggested that tangible graphs are a viable source of spatial information for blind readers. (Author/MC)

  7. Exploring the "Black Box" of Programming: Applying Systematic Implementation Evaluation to a Structured Camp Curriculum

    Science.gov (United States)

    Mainieri, Tracy L.; Anderson, Denise M.

    2015-01-01

    Camp scholars have designed structured curricula to engender specific outcomes and to break down the "black box" of programming. Implementation evaluation explores how well a program operates when delivered, further breaking down the black box. The purpose of this study was to explore the implementation of a new structured camp…

  8. Grade Inflation and Student Individual Differences as Systematic Bias in Faculty Evaluations

    Science.gov (United States)

    Germain, Marie-Line; Scandura, Terri A.

    2005-01-01

    The media has recently exposed that grade inflation is a concern for higher education in North America. Grade inflation may be due to consumerism by universities that now compete for students. Keeping students happy (and paying) may have been emphasized more than learning. We review the literature on faculty evaluation and present a model that…

  9. Instruments for the assessment of suicide risk: A systematic review evaluating the certainty of the evidence.

    Directory of Open Access Journals (Sweden)

    Bo Runeson

    Full Text Available Instruments have been developed to facilitate suicide risk assessment. We aimed to evaluate the evidence for these instruments including assessment of risk of bias and diagnostic accuracy for suicide and suicide attempt.PubMed (NLM, PsycInfo, Embase, Cinahl and the Cochrane Library databases were searched until December 2014. We assessed risk of bias with QUADAS-2. The average sensitivity and specificity of each instrument was estimated and the certainty of the evidence was assessed with GRADE. We considered instruments with a sensitivity > 80% and a specificity > 50% to have sufficient diagnostic accuracy.Thirty-five relevant studies were identified but 14 were considered to have high risk of bias, leaving 21 studies evaluating altogether 15 risk assessment instruments. We could carry out meta-analyses for five instruments. For the outcome suicide attempt SAD PERSONS Scale had a sensitivity of 15% (95% CI 8-24 and specificity of 97% (96-98, and the Manchester Self-Harm Rule (MSHR a sensitivity of 97% (97-97 and a specificity of 20% (20-21. ReACT, which is a modification of MSHR, had a similar low specificity, as did the Sodersjukhuset Self Harm Rule. For the outcome suicide, the Beck Hopelessness Scale had a sensitivity of 89% (78-95 and specificity of 42% (40-43.Most suicide risk assessment instruments were supported by too few studies to allow for evaluation of accuracy. Among those that could be evaluated, none fulfilled requirements for sufficient diagnostic accuracy.

  10. Using Eye Trackers for Usability Evaluation of Health Information Technology: A Systematic Literature Review

    Science.gov (United States)

    Yang, Yushi

    2015-01-01

    Background Eye-tracking technology has been used to measure human cognitive processes and has the potential to improve the usability of health information technology (HIT). However, it is still unclear how the eye-tracking method can be integrated with other traditional usability methodologies to achieve its full potential. Objective The objective of this study was to report on HIT evaluation studies that have used eye-tracker technology, and to envision the potential use of eye-tracking technology in future research. Methods We used four reference databases to initially identify 5248 related papers, which resulted in only 9 articles that met our inclusion criteria. Results Eye-tracking technology was useful in finding usability problems in many ways, but is still in its infancy for HIT usability evaluation. Limited types of HITs have been evaluated by eye trackers, and there has been a lack of evaluation research in natural settings. Conclusions More research should be done in natural settings to discover the real contextual-based usability problems of clinical and mobile HITs using eye-tracking technology with more standardized methodologies and guidance. PMID:27026079

  11. A Systematic Evaluation of Analogs for the Read-across Prediction of Estrogenicity (Future Tox III)

    Science.gov (United States)

    Read-across is a data gap filling technique which is commonly used within category and analog approaches to predict a biological property for a target data-poor chemical using known information from similar (analog) chemical(s). Analog identification and evaluation are critical ...

  12. A systematic review of economic evaluation studies of tuberculosis control in high-income countries

    NARCIS (Netherlands)

    J.E. Verdier (Jesse Eduard); S.J. de Vlas (Sake); R.M.P.M. Baltussen (Rob); J.H. Richardus (Jan Hendrik)

    2011-01-01

    textabstractTuberculosis (TB) is a leading cause of death in developing countries and an important health threat in the industrialised world. Ideally, interventions in TB control are effective, acceptable and economically attractive. This review summarises all economic evaluation studies of TB

  13. Psychometric evaluation of osteoarthritis questionnaires: a systematic review of the literature.

    NARCIS (Netherlands)

    Veenhof, C.; Bijlsma, J.W.J.; Ende, C.H.M. van den; Dijk, G.M. van; Pisters, M.F.; Dekker, J.

    2006-01-01

    The objective of this article was to give an overview of published self-assessment (self-administered and interview-based) instruments on pain, physical function, and patient global assessment for patients with hip and/or knee osteoarthritis. To evaluate the selected questionnaires, data on the

  14. Psychometric evaluation of osteoarthritis questionnaires: a systematic review of the literature.

    NARCIS (Netherlands)

    Veenhof, C.; Bijlsma, J.W.J.; Ende, C.H.M. van den; Dijk, G.M. van; Pisters, M.F.; Dekker, J.

    2006-01-01

    Objective: 1. To identify and describe all available questionnaires designed to assess pain, physical function and patient global assessment in patient with osteoarthritis (OA) of hip and/or knee. 2. To evaluate evidence for the psychometric qualities of these questionnaires. Methods: Instruments

  15. Instruments for the assessment of suicide risk: A systematic review evaluating the certainty of the evidence.

    Science.gov (United States)

    Runeson, Bo; Odeberg, Jenny; Pettersson, Agneta; Edbom, Tobias; Jildevik Adamsson, Ingalill; Waern, Margda

    2017-01-01

    Instruments have been developed to facilitate suicide risk assessment. We aimed to evaluate the evidence for these instruments including assessment of risk of bias and diagnostic accuracy for suicide and suicide attempt. PubMed (NLM), PsycInfo, Embase, Cinahl and the Cochrane Library databases were searched until December 2014. We assessed risk of bias with QUADAS-2. The average sensitivity and specificity of each instrument was estimated and the certainty of the evidence was assessed with GRADE. We considered instruments with a sensitivity > 80% and a specificity > 50% to have sufficient diagnostic accuracy. Thirty-five relevant studies were identified but 14 were considered to have high risk of bias, leaving 21 studies evaluating altogether 15 risk assessment instruments. We could carry out meta-analyses for five instruments. For the outcome suicide attempt SAD PERSONS Scale had a sensitivity of 15% (95% CI 8-24) and specificity of 97% (96-98), and the Manchester Self-Harm Rule (MSHR) a sensitivity of 97% (97-97) and a specificity of 20% (20-21). ReACT, which is a modification of MSHR, had a similar low specificity, as did the Sodersjukhuset Self Harm Rule. For the outcome suicide, the Beck Hopelessness Scale had a sensitivity of 89% (78-95) and specificity of 42% (40-43). Most suicide risk assessment instruments were supported by too few studies to allow for evaluation of accuracy. Among those that could be evaluated, none fulfilled requirements for sufficient diagnostic accuracy.

  16. Low health literacy and evaluation of online health information: A systematic review of the literature

    NARCIS (Netherlands)

    Diviani, N.; van den Putte, B.; Giani, S.; van Weert, J.C.M.

    2015-01-01

    Background: Recent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to

  17. Using theory of change to design and evaluate public health interventions: a systematic review.

    Science.gov (United States)

    Breuer, Erica; Lee, Lucy; De Silva, Mary; Lund, Crick

    2016-05-06

    Despite the increasing popularity of the theory of change (ToC) approach, little is known about the extent to which ToC has been used in the design and evaluation of public health interventions. This review aims to determine how ToCs have been developed and used in the development and evaluation of public health interventions globally. We searched for papers reporting the use of "theory of change" in the development or evaluation of public health interventions in databases of peer-reviewed journal articles such as Scopus, Pubmed, PsychInfo, grey literature databases, Google and websites of development funders. We included papers of any date, language or study design. Both abstracts and full text papers were double screened. Data were extracted and narratively and quantitatively summarised. A total of 62 papers were included in the review. Forty-nine (79 %) described the development of ToC, 18 (29 %) described the use of ToC in the development of the intervention and 49 (79 %) described the use of ToC in the evaluation of the intervention. Although a large number of papers were included in the review, their descriptions of the ToC development and use in intervention design and evaluation lacked detail. The use of the ToC approach is widespread in the public health literature. Clear reporting of the ToC process and outputs is important to strengthen the body of literature on practical application of ToC in order to develop our understanding of the benefits and advantages of using ToC. We also propose a checklist for reporting on the use of ToC to ensure transparent reporting and recommend that our checklist is used and refined by authors reporting the ToC approach.

  18. Establishing consensus on the definition of an isolated hip fracture for trauma system performance evaluation: A systematic review

    Directory of Open Access Journals (Sweden)

    Judith Tiao

    2014-01-01

    Full Text Available Background: Risk-adjusted mortality is widely used to benchmark trauma center care. Patients presenting with isolated hip fractures (IHFs are usually excluded from these evaluations. However, there is no standardized definition of an IHF. We aimed to evaluate whether there is consensus on the definition of an IHF used as an exclusion criterion in studies evaluating the performance of trauma centers in terms of mortality. Materials and Methods: We conducted a systematic review of observational studies. We searched the electronic databases MEDLINE, EMBASE, BIOSIS, The Cochrane Library, CINAHL, TRIP Database, and PROQUEST for cohort studies that presented data on mortality to assess the performance of trauma centers and excluded IHF. A standardized, piloted data abstraction form was used to extract data on study settings, IHF definitions and methodological quality of included studies. Consensus was considered to be reached if more than 50% of studies used the same definition of IHF. Results: We identified 8,506 studies of which 11 were eligible for inclusion. Only two studies (18% used the same definition of an IHF. Three (27% used a definition based on Abbreviated Injury Scale (AIS Codes and five (45% on International Classification of Diseases (ICD codes. Four (36% studies had inclusion criteria based on age, five (45% on secondary injuries, and four (36% on the mechanism of injury. Eight studies (73% had good overall methodological quality. Conclusions: We observed important heterogeneity in the definition of an IHF used as an exclusion criterion in studies evaluating the performance of trauma centers. Consensus on a standardized definition is needed to improve the validity of evaluations of the quality of trauma care.

  19. Systematic evaluation of factors controlling Perkinsus marinus transmission dynamics in lower Chesapeake Bay.

    Science.gov (United States)

    Ragone Calvo, Lisa M; Dungan, Christopher F; Roberson, Bob S; Burreson, Eugene M

    2003-08-15

    The transmission of Perkinsus marinus in eastern oysters Crassostrea virginica in relation to water temperature, host oyster mortality, and water-column abundance of anti-P. marinus antibody-labeled cells was systematically examined for 20 mo at a site in the lower York River, Virginia, USA. Uninfected sentinel oysters were naturally exposed to the parasite at 2 wk intervals throughout the course of the study to determine the periodicity and rates of parasite transmission. The timing and magnitude of disease-associated oyster mortalities in a local P. marinus-infected oyster population were estimated by monitoring a captive subset of the local oyster population. Flow cytometric immunodetection methods were employed to estimate the abundance of P. marinus cells in water samples collected 3 times each week. The acquisition of P. marinus infections by naïve sentinel oysters occurred sporadically at all times of the year; however, the highest incidence of infection occurred during the months of August and September. This window of maximum parasite transmission coincided with the death of infected hosts within the captive local oyster population. Counts of antibody-labeled cells ranged from 10 to 11900 cells l(-1), with the highest abundances in July and August coincident with maximum summer temperatures. A statistically significant relationship between water-column parasite abundance and infection-acquisition rate was not observed; however, highest parasite-transmission rates in both years occurred during periods of elevated water-column abundance of parasite cells. These results support the prevailing model of P. marinus transmission dynamics by which maximum transmission rates are observed during periods of maximum P. marinus-associated host mortality. However, our results also indicate that transmission can occur when host mortality is low or absent, so alternative mortality-independent dissemination mechanisms are likely. The results also suggest that atypically

  20. Vitamin K to prevent fractures in older women: systematic review and economic evaluation.

    Science.gov (United States)

    Stevenson, M; Lloyd-Jones, M; Papaioannou, D

    2009-09-01

    To determine the clinical and cost-effectiveness of vitamin K in preventing osteoporotic fractures in postmenopausal women. Searches were conducted in May 2007 in MEDLINE, MEDLINE In-Process, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, BIOSIS, CINAHL, DARE, NHS EED and HTA databases, AMED, NRR, Science Citation Index and Current Controlled Trials. The MEDLINE search was updated in March 2009. Selected studies were assessed and subjected to data extraction and quality assessment using standard methods. Where appropriate, meta-analysis was carried out. A mathematical model was constructed to estimate the cost-effectiveness of vitamin K1. The electronic literature searches identified 1078 potentially relevant articles. Of these, 14 articles relating to five trials that compared vitamin K with a relevant comparator in postmenopausal women with osteoporosis or osteopenia met the review inclusion criteria. The double-blind ECKO trial compared 5 mg of phylloquinone (vitamin K1) with placebo in Canadian women with osteopenia but without osteoporosis. Four open-label trials used 45 mg of menatetrenone (vitamin K2) in Japanese women with osteoporosis; the comparators were no treatment, etidronate or calcium. The methodological quality of the ECKO trial was good; however, all four menatetrenone trials were poorly reported and three were very small (n vitamin K were found and a mathematical model was thus constructed to estimate the cost-effectiveness of vitamin K1. Comparators were alendronate, risedronate and strontium ranelate. Vitamin K1 and alendronate were markedly more cost-effective than either risedronate or strontium ranelate. The base-case results favoured vitamin K1, but this relied on many assumptions, particularly on the efficacy of preventing hip and vertebral fractures. Calculation of the expected value of sampled information was conducted assuming a randomised controlled trial of 5 years' duration comparing alendronate

  1. Evaluation of oxidative stress in oral lichen planus using malonaldehyde: A systematic review

    OpenAIRE

    Mishra, Shovna Shivani; T N Uma Maheswari

    2014-01-01

    Background: Oral lichen planus is a chronic, mucocutaneous, inflammatory disease, with an unknown aetiology. Reactive Oxygen Species and oxidative damage to the tissues might be the cause. Malonaldehyde, a low molecular weight end product of lipid peroxidation reaction is a suitable biomarker of endogenous DNA damage. Aims: To analyse the existing literature on the “evaluation of oxidative stress in oral lichen planus using malonaldehyde as a biomarker”. Methods: Electronic search of sc...

  2. Economic evaluations of Internet interventions for mental health: a systematic review.

    Science.gov (United States)

    Donker, T; Blankers, M; Hedman, E; Ljótsson, B; Petrie, K; Christensen, H

    2015-12-01

    Internet interventions are assumed to be cost-effective. However, it is unclear how strong this evidence is, and what the quality of this evidence is. A comprehensive literature search (1990-2014) in Medline, EMBASE, the Cochrane Central Register of Controlled Trials, NHS Economic Evaluations Database, NHS Health Technology Assessment Database, Office of Health Economics Evaluations Database, Compendex and Inspec was conducted. We included economic evaluations alongside randomized controlled trials of Internet interventions for a range of mental health symptoms compared to a control group, consisting of a psychological or pharmaceutical intervention, treatment-as-usual (TAU), wait-list or an attention control group. Of the 6587 abstracts identified, 16 papers met the inclusion criteria. Nine studies featured a societal perspective. Results demonstrated that guided Internet interventions for depression, anxiety, smoking cessation and alcohol consumption had favourable probabilities of being more cost-effective when compared to wait-list, TAU, group cognitive behaviour therapy (CBGT), attention control, telephone counselling or unguided Internet CBT. Unguided Internet interventions for suicide prevention, depression and smoking cessation demonstrated cost-effectiveness compared to TAU or attention control. In general, results from cost-utility analyses using more generic health outcomes (quality of life) were less favourable for unguided Internet interventions. Most studies adhered reasonably to economic guidelines. Results of guided Internet interventions being cost-effective are promising with most studies adhering to publication standards, but more economic evaluations are needed in order to determine cost-effectiveness of Internet interventions compared to the most cost-effective treatment currently available.

  3. Economic evaluations of occupational health interventions from a corporate perspective - a systematic review of methodological quality.

    Science.gov (United States)

    Uegaki, Kimi; de Bruijne, Martine C; Lambeek, Ludeke; Anema, Johannes R; van der Beek, Allard J; van Mechelen, Willem; van Tulder, Maurits W

    2010-06-01

    Using a standardized quality criteria list, we appraised the methodological quality of economic evaluations of occupational safety and health (OSH) interventions conducted from a corporate perspective. The primary literature search was conducted in Medline and Embase. Supplemental searches were conducted in the Cochrane NHS Economic Evaluation Database, the National Institute for Occupational Safety and Health (NIOSH) database, the Ryerson International Labour, Occupational Safety and Health Index, scans of reference lists, and researchers' own literature database. Independently, two researchers selected articles based on title, keywords, and abstract, and if needed, fulltext. Disagreements were resolved by a consensus procedure. Articles were selected based on seven criteria addressing study population, type of intervention, comparative intervention, outcome, costs, language, and perspective. Two reviewers independently judged methodological quality using the Consensus on Health Economic Criteria (CHEC-list), a 19-item standardized quality criteria list. Disagreements in judgment were also resolved by consensus. Data were analyzed descriptively. A total of 34 studies were included. Of these, only 44% of the studies met more than 50% of the quality criteria. Of the 19 quality criteria, 8 were met by 50% or more of the studies. The 11 least fulfilled criteria related to (i) performance of a sensitivity analysis, (ii) selection of perspective, (iii) description of study population, (iv) discussion of generalizability, (v) description of competing alternatives, (vi) presentation of the research question, (vii) measurement of outcomes, (viii) measurement of costs, (ix) valuation of costs, (x) declaration of researchers' independence, and (xi) discussion of ethical and distributional issues. Apart from a few exceptions, the overall methodological quality of the economic evaluations of OSH interventions from a corporate perspective was poor. As such, there is a risk of

  4. Molecular adsorption on silicon (001: A systematic evaluation of size effects in slab and cluster models

    Directory of Open Access Journals (Sweden)

    D. F. Tracey

    2013-04-01

    Full Text Available First-principles calculations are in wide use today to describe chemical processes occurring on the silicon (001 surface. The number of atoms that can be explicitly treated is limited and hence size-constraints are invariably required; this applies to both cluster and periodic slab approaches. Using a trial set of seven molecular adsorbate configurations, we examine the dependence of calculated adsorption energies on several size parameters, namely thickness and in-plane unit cell size for slab models, as well as thickness, length, and width for cluster models. Size-converged adsorption energies are estimated by extrapolation, and are used to assess the accuracy of the more typically-sized slabs and clusters in common use today. Use of a DFT method that can be applied to both slabs and clusters allows us to assess the performance of these two approaches on an equal footing.

  5. The concept of dependence as developed by Birtchnell: a critical evaluation.

    Science.gov (United States)

    Cadbury, S

    1991-09-01

    Birtchnell (1988) appeals for an accurate definition of dependence. Such accuracy would help with measurement, prevention and treatment of depression. He describes dependence as a developmental deficiency. In so doing, he presupposes a psychodynamic trait-based, and gender-related development model, but does not acknowledge its influence on his thinking. Birtchnell's analysis has three types of problem. The reasoning may be questioned because of faulty inferential leaps, undue reliance on the concept of 'maturity', the use of a tautology, ('The dependent person is...dependent'), internal contradictions, and a questionable analogy between children's and adults' behaviour. Secondly, he appears to suggest that there is empirical evidence to support his theoretical approach, but he does not provide explicit evidence. He draws conclusions about causal links and neglects alternative interpretations, especially the transactional interpersonal element in social relationships. Finally, the analysis is potentially weakened by what may be described as an androcentric bias and relies upon a 'medical model' of psychological disorder, which fails to consider the impact of social influences on the expression of emotion. The author argues that it is at present premature and inappropriate to define dependence, but appeals for methods of research which would be more helpful in understanding it.

  6. Development and psychometric evaluation of the psychological cigarette dependence scale for male smokers in taiwan.

    Science.gov (United States)

    Huang, Chih-Ling; Cheng, Chung-Ping; Wang, Hsiu-Hung

    2014-06-01

    The influence of psychological factors on cigarette dependence often surpasses the direct effects of the nicotine itself. Researcher opinions on the nature and extent of psychological contributors to cigarette dependence vary widely. This study develops and psychometrically tests the Psychological Cigarette Dependence Scale (PCDS) for male smokers in Taiwan. The PCDS was developed using domain identification, individual interviews for item generation, expert reviews, and testing for construct validity and instrument stability. After initial item analysis, the PCDS was tested for concurrent and construct validity and reliability on 256 adult male smokers recruited from community centers, trade and business organizations, private companies, and factories in southern Taiwan. Participants were limited to adult men because female smokers are a small (4.1%) proportion of the female population in Taiwan and thus are difficult to recruit in statistically significant numbers. Exploratory factor analysis showed that lifelong binding and health concerns are the two predominating factors addressed by the 37-item PCDS. The PCDS correlated positively with the Fagerstrom questionnaire (r = .54, p psychological cigarette dependence. Assessment results may help nursing professionals focus on smoking cessation interventions that are tailored to the patterns and severity of patients' psychological cigarette dependence.

  7. Fractality Evidence and Long-Range Dependence on Capital Markets: a Hurst Exponent Evaluation

    Science.gov (United States)

    Oprean, Camelia; Tănăsescu, Cristina

    2014-07-01

    Since the existence of market memory could implicate the rejection of the efficient market hypothesis, the aim of this paper is to find any evidence that selected emergent capital markets (eight European and BRIC markets, namely Hungary, Romania, Estonia, Czech Republic, Brazil, Russia, India and China) evince long-range dependence or the random walk hypothesis. In this paper, the Hurst exponent as calculated by R/S fractal analysis and Detrended Fluctuation Analysis is our measure of long-range dependence in the series. The results reinforce our previous findings and suggest that if stock returns present long-range dependence, the random walk hypothesis is not valid anymore and neither is the market efficiency hypothesis.

  8. Eysenbach, Tuische and Diepgen’s Evaluation of Web Searching for Identifying Unpublished Studies for Systematic Reviews: An Innovative Study Which is Still Relevant Today.

    Directory of Open Access Journals (Sweden)

    Simon Briscoe

    2016-09-01

    Full Text Available A Review of: Eysenbach, G., Tuische, J. & Diepgen, T.L. (2001. Evaluation of the usefulness of Internet searches to identify unpublished clinical trials for systematic reviews. Medical Informatics and the Internet in Medicine, 26(3, 203-218. http://dx.doi.org/10.1080/14639230110075459 Objective – To consider whether web searching is a useful method for identifying unpublished studies for inclusion in systematic reviews. Design – Retrospective web searches using the AltaVista search engine were conducted to identify unpublished studies – specifically, clinical trials – for systematic reviews which did not use a web search engine. Setting – The Department of Clinical Social Medicine, University of Heidelberg, Germany. Subjects – n/a Methods – Pilot testing of 11 web search engines was carried out to determine which could handle complex search queries. Pre-specified search requirements included the ability to handle Boolean and proximity operators, and truncation searching. A total of seven Cochrane systematic reviews were randomly selected from the Cochrane Library Issue 2, 1998, and their bibliographic database search strategies were adapted for the web search engine, AltaVista. Each adaptation combined search terms for the intervention, problem, and study type in the systematic review. Hints to planned, ongoing, or unpublished studies retrieved by the search engine, which were not cited in the systematic reviews, were followed up by visiting websites and contacting authors for further details when required. The authors of the systematic reviews were then contacted and asked to comment on the potential relevance of the identified studies. Main Results – Hints to 14 unpublished and potentially relevant studies, corresponding to 4 of the 7 randomly selected Cochrane systematic reviews, were identified. Out of the 14 studies, 2 were considered irrelevant to the corresponding systematic review by the systematic review authors. The

  9. Educational interventions for preventing vascular catheter bloodstream infections in critical care: evidence map, systematic review and economic evaluation.

    Science.gov (United States)

    Frampton, Geoff K; Harris, Petra; Cooper, Keith; Cooper, Tracey; Cleland, Jennifer; Jones, Jeremy; Shepherd, Jonathan; Clegg, Andrew; Graves, Nicholas; Welch, Karen; Cuthbertson, Brian H

    2014-02-01

    Bloodstream infections resulting from intravascular catheters (catheter-BSI) in critical care increase patients' length of stay, morbidity and mortality, and the management of these infections and their complications has been estimated to cost the NHS annually £19.1-36.2M. Catheter-BSI are thought to be largely preventable using educational interventions, but guidance as to which types of intervention might be most clinically effective is lacking. To assess the effectiveness and cost-effectiveness of educational interventions for preventing catheter-BSI in critical care units in England. Sixteen electronic bibliographic databases - including MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, Cumulative Index to Nursing and Allied Health Literature (CINAHL), NHS Economic Evaluation Database (NHS EED), EMBASE and The Cochrane Library databases - were searched from database inception to February 2011, with searches updated in March 2012. Bibliographies of systematic reviews and related papers were screened and experts contacted to identify any additional references. References were screened independently by two reviewers using a priori selection criteria. A descriptive map was created to summarise the characteristics of relevant studies. Further selection criteria developed in consultation with the project Advisory Group were used to prioritise a subset of studies relevant to NHS practice and policy for systematic review. A decision-analytic economic model was developed to investigate the cost-effectiveness of educational interventions for preventing catheter-BSI. Seventy-four studies were included in the descriptive map, of which 24 were prioritised for systematic review. Studies have predominantly been conducted in the USA, using single-cohort before-and-after study designs. Diverse types of educational intervention appear effective at reducing the incidence density of catheter-BSI (risk ratios statistically significantly educational intervention in

  10. Spinal cord stimulation for chronic pain of neuropathic or ischaemic origin: systematic review and economic evaluation.

    Science.gov (United States)

    Simpson, E L; Duenas, A; Holmes, M W; Papaioannou, D; Chilcott, J

    2009-03-01

    This report addressed the question 'What is the clinical and cost-effectiveness of spinal cord stimulation (SCS) in the management of chronic neuropathic or ischaemic pain?' Thirteen electronic databases [including MEDLINE (1950-2007), EMBASE (1980-2007) and the Cochrane Library (1991-2007)] were searched from inception; relevant journals were hand-searched; and appropriate websites for specific conditions causing chronic neuropathic/ischaemic pain were browsed. Literature searches were conducted from August 2007 to September 2007. A systematic review of the literature sought clinical and cost-effectiveness data for SCS in adults with chronic neuropathic or ischaemic pain with inadequate response to medical or surgical treatment other than SCS. Economic analyses were performed to model the cost-effectiveness and cost-utility of SCS in patients with neuropathic or ischaemic pain. From approximately 6000 citations identified, 11 randomised controlled trials (RCTs) were included in the clinical effectiveness review: three of neuropathic pain and eight of ischaemic pain. Trials were available for the neuropathic conditions failed back surgery syndrome (FBSS) and complex regional pain syndrome (CRPS) type I, and they suggested that SCS was more effective than conventional medical management (CMM) or reoperation in reducing pain. The ischaemic pain trials had small sample sizes, meaning that most may not have been adequately powered to detect clinically meaningful differences. Trial evidence failed to demonstrate that pain relief in critical limb ischaemia (CLI) was better for SCS than for CMM; however, it suggested that SCS was effective in delaying refractory angina pain onset during exercise at short-term follow-up, although not more so than coronary artery bypass grafting (CABG) for those patients eligible for that surgery. The results for the neuropathic pain model suggested that the cost-effectiveness estimates for SCS in patients with FBSS who had inadequate

  11. Ablative therapy for people with localised prostate cancer: a systematic review and economic evaluation.

    Science.gov (United States)

    Ramsay, Craig R; Adewuyi, Temitope E; Gray, Joanne; Hislop, Jenni; Shirley, Mark D F; Jayakody, Shalmini; MacLennan, Graeme; Fraser, Cynthia; MacLennan, Sara; Brazzelli, Miriam; N'Dow, James; Pickard, Robert; Robertson, Clare; Rothnie, Kieran; Rushton, Stephen P; Vale, Luke; Lam, Thomas B

    2015-07-01

    For people with localised prostate cancer, active treatments are effective but have significant side effects. Minimally invasive treatments that destroy (or ablate) either the entire gland or the part of the prostate with cancer may be as effective and cause less side effects at an acceptable cost. Such therapies include cryotherapy, high-intensity focused ultrasound (HIFU) and brachytherapy, among others. This study aimed to determine the relative clinical effectiveness and cost-effectiveness of ablative therapies compared with radical prostatectomy (RP), external beam radiotherapy (EBRT) and active surveillance (AS) for primary treatment of localised prostate cancer, and compared with RP for salvage treatment of localised prostate cancer which has recurred after initial treatment with EBRT. MEDLINE (1946 to March week 3, 2013), MEDLINE In-Process & Other Non-Indexed Citations (29 March 2013), EMBASE (1974 to week 13, 2013), Bioscience Information Service (BIOSIS) (1956 to 1 April 2013), Science Citation Index (1970 to 1 April 2013), Cochrane Central Register of Controlled Trials (CENTRAL) (issue 3, 2013), Cochrane Database of Systematic Reviews (CDSR) (issue 3, 2013), Database of Abstracts of Reviews of Effects (DARE) (inception to March 2013) and Health Technology Assessment (HTA) (inception to March 2013) databases were searched. Costs were obtained from NHS sources. Evidence was drawn from randomised controlled trials (RCTs) and non-RCTs, and from case series for the ablative procedures only, in people with localised prostate cancer. For primary therapy, the ablative therapies were cryotherapy, HIFU, brachytherapy and other ablative therapies. The comparators were AS, RP and EBRT. For salvage therapy, the ablative therapies were cryotherapy and HIFU. The comparator was RP. Outcomes were cancer related, adverse effects (functional and procedural) and quality of life. Two reviewers extracted data and carried out quality assessment. Meta-analysis used a Bayesian

  12. Shock Analysis Method for Systematic Performance Evaluation of Component Embedded in Handheld Electronic Devices

    OpenAIRE

    Chin, C S

    2006-01-01

    It is important to identify the robustness of product (or embedded component inside the product) against shock due to free drop. With the increasing mobile and fast-paced lifestyle of the average consumer, much is required of the products; such as consumers expect mobile products to continue to operate after drop impact. Since free drop test is commonly used to evaluate the robustness of small component embedded in MP3 player, it is difficult to produce a repeatable shock reading due to highl...

  13. How to prepare a systematic review of economic evaluations for informing evidence-based healthcare decisions: a five-step approach (part 1/3).

    Science.gov (United States)

    van Mastrigt, Ghislaine A P G; Hiligsmann, Mickaël; Arts, Jacobus J C; Broos, Pieter H; Kleijnen, Jos; Evers, Silvia M A A; Majoie, Marian H J M

    2016-12-01

    Systematic reviews of economic evaluations are useful for synthesizing economic evidence about health interventions and for informing evidence-based decisions. Areas covered: As there is no detailed description of the methods for performing a systematic review of economic evidence, this paper aims to provide an overview of state-of-the-art methodology. This is laid out in a 5-step approach, as follows: step 1) initiating a systematic review; step 2) identifying (full) economic evaluations; step 3) data extraction, risk of bias and transferability assessment; step 4) reporting results; step 5) discussion and interpretation of findings. Expert commentary: The paper aims to help inexperienced reviewers and clinical practice guideline developers, but also to be a resource for experts in the field who want to check on current methodological developments.

  14. A systematic review to evaluate exercise for anterior cruciate ligament injuries: does this approach reduce the incidence of knee osteoarthritis?

    Directory of Open Access Journals (Sweden)

    Duncan KJ

    2016-01-01

    Full Text Available Koji J Duncan, Jaclyn N Chopp-Hurley, Monica R Maly School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada Purpose: Among a variety of conservative and surgical options to treat anterior cruciate ligament (ACL injuries, we do not understand which options could potentially prevent knee osteoarthritis (OA. The aim of this systematic review was to examine the evidence pertaining to exercise treatment of ACL injuries in the context of knee OA. Methods: Medline, Embase, CINAHL, PubMed, and PEDro (Physiotherapy Evidence Database databases were systematically searched using keywords encompassed within four primary key terms: knee, osteoarthritis, anterior cruciate ligament, and exercise. Clinical studies evaluating the effect of an exercise treatment for ACL injuries on the development of knee OA in adult humans were included. The PEDro scale was used to critically assess the studies included in the review. Results: Eighteen studies were included in this review, with a median PEDro score of 6/11 (range, 2/11–9/11. Three studies provided statistical evidence that exercise following ACL injury lowered the risk for knee OA development. Nine studies demonstrated no benefit of exercise in preventing knee OA incidence relative to either operative treatment or the contralateral, unaffected knee. However, exercise resulted in higher knee instability. Nonetheless, there were no significant differences in subjective or objective knee outcomes for early versus late ACL reconstruction. Limitations: This review was not registered through PROSPERO. Conclusion: The relationship between a rehabilitative exercise for ACL injuries and long-term knee OA prevalence is inconclusive. However, research suggests initial conservative treatment with optional late ACL reconstruction because this treatment strategy may reduce the risk of knee OA. More research, ideally randomized controlled trials or comparable designs, is required prior to establishing

  15. Does design matter? Systematic evaluation of the impact of analytical choices on effect estimates in observational studies.

    Science.gov (United States)

    Madigan, David; Ryan, Patrick B; Schuemie, Martijn

    2013-04-01

    Clinical studies that use observational databases, such as administrative claims and electronic health records, to evaluate the effects of medical products have become commonplace. These studies begin by selecting a particular study design, such as a case control, cohort, or self-controlled design, and different authors can and do choose different designs for the same clinical question. Furthermore, published papers invariably report the study design but do not discuss the rationale for the specific choice. Studies of the same clinical question with different designs, however, can generate different results, sometimes with strikingly different implications. Even within a specific study design, authors make many different analytic choices and these too can profoundly impact results. In this paper, we systematically study heterogeneity due to the type of study design and due to analytic choices within study design. We conducted our analysis in 10 observational healthcare databases but mostly present our results in the context of the GE Centricity EMR database, an electronic health record database containing data for 11.2 million lives. We considered the impact of three different study design choices on estimates of associations between bisphosphonates and four particular health outcomes for which there is no evidence of an association. We show that applying alternative study designs can yield discrepant results, in terms of direction and significance of association. We also highlight that while traditional univariate sensitivity analysis may not show substantial variation, systematic assessment of all analytical choices within a study design can yield inconsistent results ranging from statistically significant decreased risk to statistically significant increased risk. Our findings show that clinical studies using observational databases can be sensitive both to study design choices and to specific analytic choices within study design. More attention is needed to

  16. Systematic review of the methodological quality of controlled trials evaluating Chinese herbal medicine in patients with rheumatoid arthritis

    Science.gov (United States)

    Pan, Xin; Lopez-Olivo, Maria A; Song, Juhee; Pratt, Gregory; Suarez-Almazor, Maria E

    2017-01-01

    Objectives We appraised the methodological and reporting quality of randomised controlled clinical trials (RCTs) evaluating the efficacy and safety of Chinese herbal medicine (CHM) in patients with rheumatoid arthritis (RA). Design For this systematic review, electronic databases were searched from inception until June 2015. The search was limited to humans and non-case report studies, but was not limited by language, year of publication or type of publication. Two independent reviewers selected RCTs, evaluating CHM in RA (herbals and decoctions). Descriptive statistics were used to report on risk of bias and their adherence to reporting standards. Multivariable logistic regression analysis was performed to determine study characteristics associated with high or unclear risk of bias. Results Out of 2342 unique citations, we selected 119 RCTs including 18 919 patients: 10 108 patients received CHM alone and 6550 received one of 11 treatment combinations. A high risk of bias was observed across all domains: 21% had a high risk for selection bias (11% from sequence generation and 30% from allocation concealment), 85% for performance bias, 89% for detection bias, 4% for attrition bias and 40% for reporting bias. In multivariable analysis, fewer authors were associated with selection bias (allocation concealment), performance bias and attrition bias, and earlier year of publication and funding source not reported or disclosed were associated with selection bias (sequence generation). Studies published in non-English language were associated with reporting bias. Poor adherence to recommended reporting standards (<60% of the studies not providing sufficient information) was observed in 11 of the 23 sections evaluated. Limitations Study quality and data extraction were performed by one reviewer and cross-checked by a second reviewer. Translation to English was performed by one reviewer in 85% of the included studies. Conclusions Studies evaluating CHM often fail to

  17. A systematic review of economic evaluations of seasonal influenza vaccination for the elderly population in the European Union.

    Science.gov (United States)

    Shields, Gemma E; Elvidge, Jamie; Davies, Linda M

    2017-06-10

    The Council of the European Union (EU) has recommended that action should be taken to increase influenza vaccination in the elderly population. The aims were to systematically review and critically appraise economic evaluations for influenza vaccination in the elderly population in the EU. Electronic searches of the NHS Economic Evaluation, Health Technology Assessment, MEDLINE and Embase databases were run to identify full economic evaluations. Two levels of screening were used, with explicit inclusion criteria applied by two independent reviewers at each stage. Prespecified data extraction and critical appraisal were performed on identified studies. Results were summarised qualitatively. Of the 326 search results, screening identified eight relevant studies. Results varied widely, with the incremental cost-effectiveness ratio ranging from being both more effective and cheaper than no intervention to costing €4 59 350 per life-year gained. Cost-effectiveness was most sensitive to variations in influenza strain, vaccination type and strategy, population and modelling characteristics. Most studies suggest that vaccination is cost-effective (seven of eight studies identified at least one cost-effective scenario). All but one study used economic models to synthesise data from different sources. The results are uncertain due to the methods used and the relevance and robustness of the data used. Sensitivity analysis to explore these aspects was limited. Integrated, controlled prospective clinical and economic evaluations and surveillance data are needed to improve the evidence base. This would allow more advanced modelling techniques to characterise the epidemiology of influenza more accurately and improve the robustness of cost-effectiveness estimates. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Systematic Evaluation of Industrial, Commercial, and Institutional Food Waste Management Strategies in the United States.

    Science.gov (United States)

    Hodge, Keith L; Levis, James W; DeCarolis, Joseph F; Barlaz, Morton A

    2016-08-16

    New regulations and targets limiting the disposal of food waste have been recently enacted in numerous jurisdictions. This analysis evaluated selected environmental implications of food waste management policies using life-cycle assessment. Scenarios were developed to evaluate management alternatives applicable to the waste discarded at facilities where food waste is a large component of the waste (e.g., restaurants, grocery stores, and food processors). Options considered include anaerobic digestion (AD), aerobic composting, waste-to-energy combustion (WTE), and landfilling, and multiple performance levels were considered for each option. The global warming impact ranged from approximately -350 to -45 kg CO2e Mg(-1) of waste for scenarios using AD, -190 to 62 kg CO2e Mg(-1) for those using composting, -350 to -28 kg CO2e Mg(-1) when all waste was managed by WTE, and -260 to 260 kg CO2e Mg(-1) when all waste was landfilled. Landfill diversion was found to reduce emissions, and diverting food waste from WTE generally increased emissions. The analysis further found that when a 20 year GWP was used instead of a 100 year GWP, every scenario including WTE was preferable to every scenario including landfill. Jurisdictions seeking to enact food waste disposal regulations should consider regional factors and material properties before duplicating existing statutes.

  19. First systematic evaluation of the potency of Cannabis sativa plants grown in Albania.

    Science.gov (United States)

    Bruci, Zana; Papoutsis, Ioannis; Athanaselis, Sotirios; Nikolaou, Panagiota; Pazari, Ermira; Spiliopoulou, Chara; Vyshka, Gentian

    2012-10-10

    Cannabis products (marijuana, hashish, cannabis oil) are the most frequently abused illegal substances worldwide. Delta-9-tetrahydrocannabinol (THC) is the main psychoactive component of Cannabis sativa plant, whereas cannabidiol (CBD) and cannabinol (CBN) are other major but no psychoactive constituents. Many studies have already been carried out on these compounds and chemical research was encouraged due to the legal implications concerning the misuse of marijuana. The aim of this study was to determine THC, CBD and CBN in a significant number of cannabis samples of Albanian origin, where cannabis is the most frequently used drug of abuse, in order to evaluate and classify them according to their cannabinoid composition. A GC-MS method was used, in order to assay cannabinoid content of hemp samples harvested at different maturation degree levels during the summer months and grown in different areas of Albania. This method can also be used for the determination of plant phenotype, the evaluation of psychoactive potency and the control of material quality. The highest cannabinoid concentrations were found in the flowers of cannabis. The THC concentrations in different locations of Albania ranged from 1.07 to 12.13%. The influence of environmental conditions on cannabinoid content is discussed. The cannabinoid content of cannabis plants were used for their profiling, and it was used for their classification, according to their geographical origin. The determined concentrations justify the fact that Albania is an area where cannabis is extensively cultivated for illegal purposes. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. Evaluation of TB Case Finding through Systematic Contact Investigation, Chhattisgarh, India

    Directory of Open Access Journals (Sweden)

    Kshitij Khaparde

    2015-01-01

    Full Text Available Rationale. Contact investigation is an established tool for early case detection of tuberculosis (TB. In India, contact investigation is not often conducted, despite national policy, and the yield of contact investigation is not well described. Objective. To determine the yield of evaluating household contacts of sputum smear-positive TB cases in Rajnandgaon district, Chhattisgarh, India. Methods. Among 14 public health care facilities with sputum smear microscopy services, home visits were conducted to identify household contacts of all registered sputum smear-positive TB cases. We used a standardized protocol to screen for clinical symptoms suggestive of active TB with additional referral for chest radiograph and sputa collection. Results. From December 2010 to May 2011, 1,556 household contacts of 312 sputum smear-positive TB cases were identified, of which 148 (9.5% were symptomatic. Among these, 109 (73.6% were evaluated by sputum examination resulting in 11 cases (10.1% of sputum smear-positive TB and 4 cases (3.6% of smear-negative TB. Household visits contributed additional 63% TB cases compared to passive case detection alone. Conclusion. A standard procedure for conducting household contact investigation identified additional TB cases in the community and offered an opportunity to initiate isoniazid chemoprophylaxis among children.

  1. Evaluation of endometriosis-associated pain and influence of conventional treatment: a systematic review

    Directory of Open Access Journals (Sweden)

    Alessandra Bernadete Trovó de Marqui

    2015-12-01

    Full Text Available SUMMARY Endometriosis is a chronic gynecological disease characterized by sustained painful symptoms that are responsible for a decline in the quality of life of sufferers. Conventional treatment includes surgical and pharmacological therapy aiming at reducing painful symptoms. This study aimed to evaluate pain levels in women with endometriosis, focusing on the influence of conventional treatment in controlling this variable. To do so, a literature search was conducted in the Medline/Pubmed databases, with 119 scientific articles found. After applying the inclusion and exclusion criteria, 27 were selected for reading and elaboration of this review. Thus, 9 studies evaluated the contribution of surgery, 17 the use of drugs to reduce pain levels in patients with endometriosis and one assessed surgical and medical treatment. The main results of these searches are presented and discussed in this revision. Surgery and the use of drugs provided reduced pain scores in patients with endometriosis but nevertheless exhibit disadvantages, such as risk of recurrence and side effects, respectively. Treatment of endometriosis is, therefore, a challenge for gynecologists and patients, as they must select the best therapeutic approach for this disease. However, improved quality of life in these patients has been obtained with the use of conventional treatment.

  2. A systematic evaluation of whole genome amplification of bisulfite-modified DNA

    Directory of Open Access Journals (Sweden)

    Bundo Miki

    2012-11-01

    Full Text Available Abstract Background Studying DNA methylation profiles in detail should be the first step in epigenetic research. Although sodium bisulfite modification of genomic DNA is the gold standard method for DNA methylation analysis, this method results in the loss of the majority of the DNA material. Whole genome amplification (WGA of bisulfite-modified DNA is expected to provide a rich source of materials, but its validity has not been thoroughly evaluated. In this study, we evaluated the extent of biased amplification in the WGA of bisulfite-modified DNA and the reproducibility of independent WGA reactions. We performed the multiple displacement amplification-based WGA separately three times. Each experiment included two reactions using 10 or 50 ng of bisulfite-modified DNA as template. DNA methylation levels were compared between WGA products and original bisulfite-modified DNA at about 450,000 CpG sites. Results Using a sufficient amount of bisulfite-modified DNA for WGA was critical for downstream application. The considerable deviations from original bisulfite-modified DNA were found in the middle range of DNA methylation levels. Distribution of hyper- and hypomethylation were equal, which suggested that the deviation at each CpG site occurred randomly. Averaging the data from independently amplified WGA products dramatically improved the overall quality. Conclusions WGA of bisulfite-modified DNA could be a valuable tool for epigenetic research, but careful experimental design and data interpretation are required.

  3. The evaluation of family functioning by the family assessment device: a systematic review of studies in adult clinical populations.

    Science.gov (United States)

    Staccini, Laura; Tomba, Elena; Grandi, Silvana; Keitner, Gabor I